Active NPI
Banner Urgent Care Colorado
- Urgent Care Clinic/Center
- Fort Collins, CO
National Provider Identifier
1679075253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urgent Care Clinic/Center
- Legal business name
- BANNER URGENT CARE COLORADO
- Practice address
- 3617 S College Ave Ste C
Fort Collins, CO 80525-3009 - Phone
- (970) 821-1500
- Fax
- (970) 821-1515
- NPI assigned
- Feb 28, 2018
- Last updated
- Dec 30, 2021
- Organization subpart
- Yes
- Parent organization
- BANNER HEALTH
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dennis Laraway
- Title
- Sr VP Finance
- Phone
- (602) 747-4000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Primary |
Addresses
Primary practice location
3617 S College Ave Ste C
Fort Collins, CO 80525-3009
Mailing address
2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171229002034 | CO | Part B Supplier - Clinic/Group Practice | 7214295989 |
Receives reassigned benefits from 31 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Fort Collins, CO; Loveland, CO |
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Part of
- Custer Comm Hosp Rad
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
3617 S College Ave
Ste C
Fort Collins, CO 80525
Phone (970) 821-1500
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Firestone, CO
- NPI 1568029387
-
- Family Nurse Practitioner
- Windsor, CO
- NPI 1245715671
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519776000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1640822400000",
"number": "1679075253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 N CENTRAL AVE STE 160",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850122702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3617 S COLLEGE AVE STE C",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805253009",
"telephone_number": "970-821-1500",
"fax_number": "970-821-1515"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BANNER URGENT CARE COLORADO",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BANNER HEALTH",
"enumeration_date": "2018-02-28",
"last_updated": "2021-12-30",
"certification_date": "2021-12-30",
"status": "A",
"authorized_official_last_name": "LARAWAY",
"authorized_official_first_name": "DENNIS",
"authorized_official_title_or_position": "SR VP FINANCE",
"authorized_official_telephone_number": "602-747-4000"
},
"taxonomies": [
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
- Banner Health Physicians Colorado LLC
- Banner Health Physicians Colorado LLC
- Banner Hospital Based Physicians Colorado LLC
- Banner Hospital Based Physicians Colorado LLC
- Banner Urgent Care Colorado
- Paula Nicole Bannister, DC
- Sean Bannon, LPC
- Rebecca Banton, IOMT
- Michael Banzhaf, CNIM
- Kimberly Sue Bappe IV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.