Individual provider Active NPI

Robbie Jill Fendley

  • Family Nurse Practitioner
  • Fort Collins, CO
National Provider Identifier
1851921050
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RXN.0104470-NP Issued in CO
Practice address
2121 E Harmony Rd Unit 310
Fort Collins, CO 80528-3403
Phone
(970) 221-3855
Fax
(970) 212-1238
NPI assigned
Jan 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RXN.0104470-NP CO Primary

Addresses

Primary practice location

2121 E Harmony Rd Unit 310
Fort Collins, CO 80528-3403

Mailing address

2121 E Harmony Rd Unit 310
Fort Collins, CO 80528-3403
Phone (970) 221-3855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200309002152 CO Practitioner - Nurse Practitioner 7719315506 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RXN.0104470-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Family Medicine CurrentSince Jan 27, 2020 Accepting new patients
A Life Worth Living Past Accepting new patients

Locations

2121 E Harmony Rd
Unit 310
Fort Collins, CO 80528
Phone (970) 221-3855

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.

NPI Registry JSON

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

{
    "created_epoch": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1851921050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 E HARMONY RD UNIT 310",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283403",
            "telephone_number": "970-221-3855",
            "fax_number": "970-212-1238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E HARMONY RD UNIT 310",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283403",
            "telephone_number": "970-221-3855",
            "fax_number": "970-212-1238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENDLEY",
        "first_name": "ROBBIE",
        "middle_name": "JILL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-16",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "RXN.0104470-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.