NPIMap

Organization Active NPI

Banner Hospital Based Physicians Colorado LLC

  • Multi-Specialty Clinic/Center
  • Fort Collins, CO
National Provider Identifier
1689021040
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
BANNER HOSPITAL BASED PHYSICIANS COLORADO LLC
Practice address
608 E Harmony Rd Ste 101
Fort Collins, CO 80525-3210
Phone
(970) 204-9069
NPI assigned
May 16, 2016
Organization subpart
Yes
Parent organization
BANNER MEDICAL GROUP COLORADOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Authorized official

Name
Dennis Laraway
Title
Cfo
Phone
(602) 747-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

608 E Harmony Rd Ste 101
Fort Collins, CO 80525-3210

Mailing address

2901 N Central Ave
Phoenix, AZ 85012-2700

National Provider Directory

National Provider Directory
Tax ID family
Banner Hospital Based Physicians Colorado LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

608 E Harmony Rd
Ste 101
Fort Collins, CO 80525
Phone (970) 203-2400

NPI Registry JSON

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640736000000",
    "number": "1689021040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 N CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 E HARMONY RD STE 101",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253210",
            "telephone_number": "970-204-9069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER HOSPITAL BASED PHYSICIANS COLORADO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER MEDICAL GROUP COLORADO",
        "enumeration_date": "2016-05-16",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A",
        "authorized_official_last_name": "LARAWAY",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.