Individual provider Active NPI

Gary Allen Ludwin, MD

  • Obstetrics & Gynecology Physician
  • Fort Collins, CO
National Provider Identifier
1912971342
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
21763 Issued in CO
Practice address
1107 S Lemay Ave Ste 300
Fort Collins, CO 80524-3955
Phone
(970) 493-7442
Fax
(970) 493-2990
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 21763 CO Primary

Addresses

Primary practice location

1107 S Lemay Ave Ste 300
Fort Collins, CO 80524-3955

Mailing address

1107 S Lemay Ave
Ste 300
Fort Collins, CO 80524-3955
Phone (970) 493-7442

Other practice location 1

1024 S LeMay Ave
Fort Collins, CO 80524-3929
Phone (970) 495-8800

Other identifiers 3

IdentifierTypeStateIssuer
01217637MedicaidCO
LU84048OtherBCBS
84059624505OtherPACIFICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21763COMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Obstetrics & Gynecology PastSince Apr 30, 2003 Accepting new patients

Organizations & group practices 1

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1912971342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 S LEMAY AVE",
            "address_2": "STE 300",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243955",
            "telephone_number": "970-493-7442",
            "fax_number": "970-493-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 S LEMAY AVE STE 300",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243955",
            "telephone_number": "970-493-7442",
            "fax_number": "970-493-2990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1024 S LeMay Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805243929",
            "country_code": "US",
            "telephone_number": "970-495-8800",
            "fax_number": "970-495-8820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUDWIN",
        "first_name": "GARY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "21763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01217637",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "LU84048",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE",
            "identifier": "84059624505",
            "state": null
        }
    ],
    "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 Mar 10, 2020; 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.