NPIMap

Individual provider Active NPI

John Clifford Mann, PA-C

  • Physician Assistant
  • Loveland, CO
National Provider Identifier
1811247331
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0003564 Issued in CO
Practice address
3850 Grant Ave Ste 200
Loveland, CO 80538-8431
Phone
(970) 624-5170
NPI assigned
Sep 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0003564 CO Primary

Addresses

Primary practice location

3850 Grant Ave Ste 200
Loveland, CO 80538-8431

Mailing address

3850 Grant Ave Ste 200
Loveland, CO 80538-8431
Phone (970) 624-5170

Other practice location 1

1635 Blue Spruce Dr
Fort Collins, CO 80524-5427
Phone (970) 494-4040

Other identifiers 1

IdentifierTypeStateIssuer
36530212MedicaidCO

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
I20121025000815 CO Practitioner - Physician Assistant 5698925774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1100 E Prospect Rd
BLDG a
Fort Collins, CO 80525-5304
Phone (970) 297-6630

1106 E Prospect Rd
Building B Suite 100
Fort Collins, CO 80525-5304
Phone (970) 495-7410

2127 E Harmony Rd
Suite 140 Uchmg Harmony Urgent Care
Fort Collins, CO 80528-3406
Phone (970) 297-6250

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

4846 Larimer Pkwy
BLDG 1
Johnstown, CO 80534-9012
Phone (970) 624-2830

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0003564COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Sep 18, 2021 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 18, 2021 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

5965 Firestone Blvd
Bldg B
Firestone, CO 80504
Phone (720) 652-7055

2127 E Harmony Rd
Ste 140
Fort Collins, CO 80528
Phone (970) 207-4800

5881 W 16th St
Ste A
Greeley, CO 80634
Phone (970) 313-2700

4846 Larimer Pkwy
Bldg 1
Johnstown, CO 80534
Phone (970) 624-2830

2101 Main St
Longmont, CO 80501
Phone (720) 745-8020

221 E 29th St
Ste 102
Loveland, CO 80538
Phone (970) 224-3636

3850 Grant Ave
Ste 200
Loveland, CO 80538
Phone (970) 624-5170

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1811247331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 GRANT AVE STE 200",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805388431",
            "telephone_number": "970-624-5170",
            "fax_number": "970-669-7521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 GRANT AVE STE 200",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805388431",
            "telephone_number": "970-624-5170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1635 Blue Spruce Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805245427",
            "country_code": "US",
            "telephone_number": "970-494-4040",
            "fax_number": "970-494-4076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANN",
        "first_name": "JOHN",
        "middle_name": "CLIFFORD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-12",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0003564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36530212",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

Verify at the official NPI Registry.