NPIMap

Individual provider Active NPI

Randall C Marsh, MD

  • Cardiovascular Disease Physician
  • Greeley, CO
National Provider Identifier
1720042161
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
DR.0024016 Issued in CO
Practice address
1800 15TH St
Suite 310
Greeley, CO 80631-4500
Phone
(970) 392-0900
Fax
(970) 506-3796
NPI assigned
Apr 13, 2006
Last updated
Mar 27, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X DR.0024016 CO Primary

Addresses

Primary practice location

1800 15TH St
Suite 310
Greeley, CO 80631-4500

Mailing address

1800 15TH St
Suite 310
Greeley, CO 80631-4500
Phone (970) 392-0900

Other identifiers 1

IdentifierTypeStateIssuer
01240167MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071011000561 CO Practitioner - Cardiovascular Disease (Cardiology) 3274426564 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Texas Tech University Health Science Center School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1801 16TH St
Greeley, CO 80631-5154
Phone (970) 810-4121

1900 Boise Ave
Loveland, CO 80538-5004

2000 Boise Ave
Loveland, CO 80538-5006
Phone (970) 820-4640

4700 Lady Moon Dr
Fort Collins, CO 80528-4426

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0024016COMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Hospital Based Physicians Colorado LLC CurrentSince Oct 7, 2018 Accepting new patients
Banner Hospital Based Physicians Colorado LLC CurrentSince Oct 7, 2018 Accepting new patients
North Colorado Cardiology, PC Cardiovascular Disease Past Accepting new patients
Banner Health Physicians Colorado LLC Past Accepting new patients

Locations

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121

1900 Boise Ave
Ste 200
Loveland, CO 80538
Phone (970) 203-2120

Organizations & group practices 5

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1720042161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 15TH ST",
            "address_2": "SUITE 310",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806314500",
            "telephone_number": "970-392-0900",
            "fax_number": "970-506-3796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 15TH ST",
            "address_2": "SUITE 310",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806314500",
            "telephone_number": "970-392-0900",
            "fax_number": "970-506-3796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "RANDALL",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CO",
            "license": "DR.0024016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01240167",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.