Individual provider Active NPI

Quincy Noelle Crane, MMS, PA-C

  • Physician Assistant
  • Fort Collins, CO
National Provider Identifier
1679674634
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2312 Issued in CO
Practice address
2121 E Harmony Rd
Suite 370
Fort Collins, CO 80528
Phone
(970) 221-2290
Fax
(970) 221-2293
NPI assigned
Sep 25, 2006
Last updated
Oct 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2312 CO Primary

Addresses

Primary practice location

2121 E Harmony Rd
Suite 370
Fort Collins, CO 80528

Mailing address

2121 E Harmony Rd Unit 370
Fort Collins, CO 80528-3404
Phone (970) 221-2290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090902000307 CO Practitioner - Physician Assistant 3678628302 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2312COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado State University PastSince Oct 2, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1679674634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 E HARMONY RD UNIT 370",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283404",
            "telephone_number": "970-221-2290",
            "fax_number": "970-295-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E HARMONY RD",
            "address_2": "SUITE 370",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "80528",
            "telephone_number": "970-221-2290",
            "fax_number": "970-221-2293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANE",
        "first_name": "QUINCY",
        "middle_name": "NOELLE",
        "name_prefix": "Mrs.",
        "credential": "MMS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "2312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.