NPIMap

Organization Active NPI

Banner Fort Collins PCP LLC

  • Primary Care Clinic/Center
  • Fort Collins, CO
National Provider Identifier
1831982891
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
BANNER FORT COLLINS PCP LLC
Practice address
2025 Bighorn Rd
Fort Collins, CO 80525-3480
Phone
(970) 449-0082
NPI assigned
May 23, 2025
Last updated
Jul 30, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
BANNER MEDICAL GROUP COLORADOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Authorized official

Name
Shiva Birdi, MD
Title
Ceo
Phone
(602) 747-4000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

2025 Bighorn Rd
Fort Collins, CO 80525-3480

Mailing address

2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702

Other practice location 1

1625 Foxtrail Dr Ste 190
Loveland, CO 80538-9089
Phone (970) 500-2244

Other practice location 2

3519 Richmond Dr
Fort Collins, CO 80526-5995
Phone (970) 449-0951

Other practice location 3

1113 Oakridge Dr
Fort Collins, CO 80525-5591
Phone (970) 449-0961

Other practice location 4

205 S Main St Ste B
Longmont, CO 80501-1714
Phone (303) 772-6244

Other practice location 5

2001 S Shields St Bldg 1
Fort Collins, CO 80526-1827
Phone (970) 449-0352

Other practice location 6

1683 Main St
Windsor, CO 80550-7921
Phone (970) 400-7618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250812000406 CO Part B Supplier - Clinic/Group Practice 2567960396 Receives reassigned benefits from 54 practitioners
Practice locations: Fort Collins, CO; Longmont, CO; Loveland, CO; Windsor, CO

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • Banner Health

    dba Banner Hospice of Northern Colorado

    • Community Based Hospice Care Agency
    • Greeley, CO
    • NPI 1407409964

    Member Of

    NPD member

Locations

205 S Main St
Ste B
Longmont, CO 80501
Phone (303) 772-6244

Practitioners & affiliated clinicians

Practitioners 54

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 54

NPI Registry JSON

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

{
    "created_epoch": "1747958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753833600000",
    "number": "1831982891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 N CENTRAL AVE STE 160",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 BIGHORN RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253480",
            "telephone_number": "970-449-0082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1625 Foxtrail Dr Ste 190",
            "address_purpose": "LOCATION",
            "city": "Loveland",
            "state": "CO",
            "postal_code": "805389089",
            "country_code": "US",
            "telephone_number": "970-500-2244",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3519 Richmond Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805265995",
            "country_code": "US",
            "telephone_number": "970-449-0951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1113 Oakridge Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805255591",
            "country_code": "US",
            "telephone_number": "970-449-0961",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 S Main St Ste B",
            "address_purpose": "LOCATION",
            "city": "Longmont",
            "state": "CO",
            "postal_code": "805011714",
            "country_code": "US",
            "telephone_number": "303-772-6244",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 S Shields St Bldg 1",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805261827",
            "country_code": "US",
            "telephone_number": "970-449-0352",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1683 Main St",
            "address_purpose": "LOCATION",
            "city": "Windsor",
            "state": "CO",
            "postal_code": "805507921",
            "country_code": "US",
            "telephone_number": "970-400-7618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BANNER FORT COLLINS PCP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER MEDICAL GROUP COLORADO",
        "enumeration_date": "2025-05-23",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A",
        "authorized_official_last_name": "BIRDI",
        "authorized_official_first_name": "SHIVA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-747-4000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "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 Jul 30, 2025; 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.