NPIMap

Organization Active NPI

Bender Medical Group

Doing business as Miramont Family Medicine

  • Family Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1700193034
Registry record updated May 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32679 Issued in CO
Legal business name
BENDER MEDICAL GROUP
Doing business as
Miramont Family Medicine
Practice address
4674 Snow Mesa Dr Ste 140
Fort Collins, CO 80528-8614
Phone
(970) 225-5000
Fax
(970) 482-9646
NPI assigned
Sep 8, 2010
Last updated
May 31, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2019

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

Authorized official

Name
Julie M Desaire
Title
Practice Admin
Phone
(970) 225-5107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32679 CO Primary

Addresses

Primary practice location

4674 Snow Mesa Dr Ste 140
Fort Collins, CO 80528-8614

Mailing address

4674 Snow Mesa Dr Ste 140
Fort Collins, CO 80528-8614
Phone (970) 482-0213

Other names 1

  • Miramont Family Medicine Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmdesaire@miramont.us Direct

National Provider Directory

National Provider Directory
Tax ID family
Bender Medical GRP Inc11 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.

NPI Registry JSON

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559260800000",
    "number": "1700193034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4674 SNOW MESA DR STE 140",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805288614",
            "telephone_number": "970-482-0213",
            "fax_number": "970-482-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4674 SNOW MESA DR STE 140",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805288614",
            "telephone_number": "970-225-5000",
            "fax_number": "970-482-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENDER MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-08",
        "last_updated": "2019-05-31",
        "status": "A",
        "authorized_official_last_name": "DESAIRE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE ADMIN",
        "authorized_official_telephone_number": "970-225-5107"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "32679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmdesaire@miramont.us",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4674 Snow Mesa Dr Ste 140",
            "city": "Fort Collins",
            "state": "CO",
            "country_code": "US",
            "postal_code": "805288614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Miramont Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Miramont Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 31, 2019; 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.