Square One Health LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

SQUARE ONE HEALTH LLC

Practice address

257 Boardwalk Dr
Fort Collins, CO 80525-3661

Phone

(970) 207-4463

Fax

(970) 207-4052

NPI assigned

Mar 9, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Christopher Gubbels, DCNPI 1437313509

Title

Owner

Phone

(970) 207-4463

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy Keyo Cowan, DC

  • Chiropractor
  • Fort Collins, CO
  • NPI 1952057085

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Christopher Michael Gubbels, DC

  • Chiropractor
  • Fort Collins, CO
  • NPI 1437313509
  Medicare reassignment NPD Authorized official
• Emily Anne Souders, DNP, FNP-BC, APN

  • Family Nurse Practitioner
  • Fort Collins, CO
  • NPI 1245014828
  Medicare reassignment Care Compare group NPD
• Natasha Lynn Forgey, NP

  • Women's Health Nurse Practitioner
  • Fort Collins, CO
  • NPI 1093477200
  Medicare reassignment Care Compare group
• Joshua Thomas Werner, DC

  • Chiropractor
  • Fort Collins, CO
  • NPI 1013404037
  NPD (past)
• John Thieszen, M.D.

  • Hospitalist Physician
  • Billings, MT
  • NPI 1285667816
  NPD (past)

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

{
    "created_epoch": "1615248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615248000000",
    "number": "1790370914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4914 BROOKFIELD DR UNIT A",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283199",
            "telephone_number": "970-207-4463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 BOARDWALK DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253661",
            "telephone_number": "970-207-4463",
            "fax_number": "970-207-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SQUARE ONE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-09",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A",
        "authorized_official_last_name": "GUBBELS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-207-4463",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Sproul
• Gary Jan Spruill, DDS
• Kimberly Joy Spurlock, M.A.,CCC-SLP
• Kyle Spurlock
• Kimberly Spurny, RBT
• SSC Fort Collins Lemay Avenue Operating Company LLC (Fort Collins Health Care Center)
• SSC Fort Collins Lemay Avenue Operating Company LLC (Fort Collins Health Care Center)
• SSC Fort Collins Spring Creek Operating Company LLC (Spring Creek Healthcare Center)
• SSC Fort Collins Spring Creek Operating Company LLC (Garden Square at Spring Creek)
• St Lukes Medical Clinic LLC

• Nurse Practitioner in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.