Active NPI
Banner Fort Collins PCP LLC
- Primary Care Clinic/Center
- Fort Collins, CO
National Provider Identifier
1831982891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- 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
- Organization subpart
- Yes
- Parent organization
- BANNER MEDICAL GROUP COLORADO
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
1683 Main St
Windsor, CO 80550-7921
Phone (970) 400-7618
Other practice location 2
1113 Oakridge Dr
Fort Collins, CO 80525-5591
Phone (970) 449-0961
Other practice location 3
205 S Main St Ste B
Longmont, CO 80501-1714
Phone (303) 772-6244
Other practice location 4
1625 Foxtrail Dr Ste 190
Loveland, CO 80538-9089
Phone (970) 500-2244
Other practice location 5
3519 Richmond Dr
Fort Collins, CO 80526-5995
Phone (970) 449-0951
Other practice location 6
2001 S Shields St Bldg 1
Fort Collins, CO 80526-1827
Phone (970) 449-0352
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
2001 S Shields St
Bldg 1
Fort Collins, CO 80526
Phone (970) 221-5255
Practitioners & affiliated clinicians
Practitioners 54
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Sports Medicine (Family Medicine) Physician
- Fort Collins, CO
- NPI 1942615471
CO
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": "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"
},
{
"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": "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": "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"
}
],
"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.