NPIMap

Individual provider Active NPI

Jill Lynn Hanck, MD

  • Emergency Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1881805273
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
CO45870 Issued in CO
Practice address
1024 Lemay Ave
Fort Collins, CO 80524-3929
Phone
(970) 495-8006
NPI assigned
May 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 0101240655 VA
Emergency Medicine Physician 207P00000X CO45870 CO Primary

Addresses

Primary practice location

1024 Lemay Ave
Fort Collins, CO 80524-3929

Mailing address

1224 Forest Hills LN
Fort Collins, CO 80524-2265
Phone (970) 493-0932

Other identifiers 1

IdentifierTypeStateIssuer
36238821MedicaidCO

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
I20070830000144 CO Practitioner - Emergency Medicine 6204929680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Professionals of Colorado PCGroup PAC ID 2860706967, 41 clinicians

Practice addresses (Care Compare)

1801 16TH St
Greeley, CO 80631-5154
Phone (970) 352-4121

Hospital & facility affiliations

  • Banner North Colorado Medical Center Hospital, Greeley, CO, CCN 060001
  • Banner Fort Collins Medical Center Hospital, Fort Collins, CO, CCN 060126

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
CO45870COMDEmergency Medicine Physician
0101240655VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professionals of Colorado, PC Emergency Medicine CurrentSince Sep 1, 2015 Accepting new patients
Emergency Professionals of Colorado, PC Emergency Medicine CurrentSince Sep 1, 2015 Accepting new patients
East Morgan County Hospital Past Accepting new patients
Emergency Professionals of Colorado, PC Emergency Medicine Past Accepting new patients
Longs Peak Emergency Physicians, PC Emergency Medicine Past Accepting new patients
Emergency Professionals of Colorado, PC Emergency Medicine Past Accepting new patients
Emergency Professionals of Colorado, PC Emergency Medicine Past Accepting new patients

Locations

4700 Lady Moon Dr
Fort Collins, CO 80528
Phone (970) 521-4600

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

2000 70th Ave
Greeley, CO 80634
Phone (970) 352-7366

2000 Boise Ave
Loveland, CO 80538
Phone (970) 635-4071

615 Fairhurst St
Sterling, CO 80751
Phone (970) 521-0322

Organizations & group practices 7

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194566400000",
    "number": "1881805273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 FOREST HILLS LN",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805242265",
            "telephone_number": "970-493-0932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 LEMAY AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243929",
            "telephone_number": "970-495-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANCK",
        "first_name": "JILL",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0101240655",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "CO45870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36238821",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.