Amy Fitzgerald Pelloquin, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

DR.0056652 Issued in CO

Practice address

4674 Snow Mesa Dr
Suite 100
Fort Collins, CO 80528-8615

Phone

(970) 482-3712

Fax

(970) 266-4190

NPI assigned

Jun 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Amy J Fitzgerald Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: afitzgerald412210@directb.mercy.net

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1730117086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4674 SNOW MESA DR",
            "address_2": "SUITE 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805288615",
            "telephone_number": "970-482-3712",
            "fax_number": "970-266-4190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4674 SNOW MESA DR",
            "address_2": "SUITE 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805288615",
            "telephone_number": "970-482-3712",
            "fax_number": "970-266-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLOQUIN",
        "first_name": "AMY",
        "middle_name": "FITZGERALD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "R4536",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "R-4536",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0056652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "86330055",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "FITZGERALD",
            "middle_name": "J",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Theresa Victoria Berger Peirce, MS, RDN
• Pelletier Counseling LLC
• Christopher Pelletier, LPC
• Nicole Pelletier, LICSW
• Nancy Theresa Pellman, RN
• Joshua John Pelnar, D.O.
• David Pelster, D.D.S.
• Nancy Peltola, M.D.
• Adam Andrew Pena
• Jose Rene Pena, DO

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; 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.