Foothills Family Care, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

30253 Issued in CO

Legal business name

FOOTHILLS FAMILY CARE, LLC

Doing business as

Cory D. Carroll, M.D.

Practice address

1032 Luke St
Ste 1
Fort Collins, CO 80524-4037

Phone

(970) 221-5858

Fax

(970) 484-7191

NPI assigned

Aug 27, 2015

Organization subpart

No

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

Authorized official

Name

Cory Carroll, M.D.

Title

Owner

Phone

(970) 221-5858

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cory D. Carroll, M.D. Doing business as

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440633600000",
    "number": "1710354543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 LUKE ST",
            "address_2": "STE 1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244037",
            "telephone_number": "970-221-5858",
            "fax_number": "970-484-7191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 LUKE ST",
            "address_2": "STE 1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244037",
            "telephone_number": "970-221-5858",
            "fax_number": "970-484-7191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILLS FAMILY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-27",
        "last_updated": "2015-08-27",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-221-5858",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "30253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01302538",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cory D. Carroll, M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Ryan Fondy, PT
• Laurie Elaine Fonken, PH.D.
• Foot of the Mountains PLLC
• Foot Surgery Center of Northern Colorado LLC
• Lucas Lee Foote, LMT
• Foothills Family Dental, P.C.
• Foothills Gateway Inc
• Foothills Gateway Inc
• Foothills Gateway Inc.
• Foothills Gateway Inc.

• Family Medicine Physician in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.