NPIMap

Organization Active NPI

Bender Medical Group

Doing business as Miramont Family Medicine

  • Family Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1740596527
Registry record updated May 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
45095 Issued in CO
Legal business name
BENDER MEDICAL GROUP
Doing business as
Miramont Family Medicine
Practice address
313 W Drake Rd
Fort Collins, CO 80526-2846
Phone
(970) 482-8881
Fax
(970) 482-3253
NPI assigned
Aug 31, 2010
Last updated
May 21, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
BENDER MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 21, 2015

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

Authorized official

Name
Mrs. Teresa Bender
Title
Practice Admin
Phone
(970) 482-0213

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 45095 CO Primary

Addresses

Primary practice location

313 W Drake Rd
Fort Collins, CO 80526-2846

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

National Provider Directory

National Provider Directory
Tax ID family
Bender Medical GRP Inc11 organizations share this tax ID, including this one
Part of
Bender Medical GRP Inc

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": "1283212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432166400000",
    "number": "1740596527",
    "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": "313 W DRAKE RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805262846",
            "telephone_number": "970-482-8881",
            "fax_number": "970-482-3253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENDER MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BENDER MEDICAL GROUP",
        "enumeration_date": "2010-08-31",
        "last_updated": "2015-05-21",
        "status": "A",
        "authorized_official_last_name": "BENDER",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "PRACTICE ADMIN",
        "authorized_official_telephone_number": "970-482-0213",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "45095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "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 21, 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.