New Belgium Brewing Company, Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

35548 Issued in CO

Legal business name

NEW BELGIUM BREWING COMPANY, INC.

Practice address

702A W Drake Rd
Fort Collins, CO 80526-5521

Phone

(970) 229-4653

NPI assigned

Dec 14, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Evelyn June Tyrrell

Title

Benefits Administrator

Phone

(970) 494-7801

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450051200000",
    "number": "1912372137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LINDEN ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805242457",
            "telephone_number": "970-221-0524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702A W DRAKE RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805265521",
            "telephone_number": "970-229-4653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW BELGIUM BREWING COMPANY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-14",
        "last_updated": "2015-12-14",
        "status": "A",
        "authorized_official_last_name": "TYRRELL",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_middle_name": "JUNE",
        "authorized_official_title_or_position": "BENEFITS ADMINISTRATOR",
        "authorized_official_telephone_number": "970-494-7801",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CO",
            "license": "35548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Primary Care Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.