Active NPI
Karyn Fereday
- Specialist
- Fort Collins, CO
National Provider Identifier
1730489477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 10753
- Practice address
- 140 Boardwalk Dr
Suite a
Fort Collins, CO 80525-3153 - Phone
- (970) 223-8293
- Fax
- (970) 223-8219
- NPI assigned
- Oct 28, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 10753 | CO | Primary |
Addresses
Primary practice location
140 Boardwalk Dr
Suite a
Fort Collins, CO 80525-3153
Mailing address
140 Boardwalk Dr
Suite a
Fort Collins, CO 80525-3153
Phone (970) 223-8293
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10753 | CO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288224000000",
"number": "1730489477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 BOARDWALK DR",
"address_2": "SUITE A",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805253153",
"telephone_number": "970-223-8293",
"fax_number": "970-223-8219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 BOARDWALK DR",
"address_2": "SUITE A",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805253153",
"telephone_number": "970-223-8293",
"fax_number": "970-223-8219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEREDAY",
"first_name": "KARYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-28",
"last_updated": "2010-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CO",
"license": "10753",
"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 Oct 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.