NPIMap

Individual provider Active NPI

Allison R Nichols, PA-C

  • Physician Assistant
  • Fort Collins, CO
National Provider Identifier
1932184264
Registry record updated Oct 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0004675 Issued in CO
Practice address
1107 S Lemay Ave
Suite 240
Fort Collins, CO 80524-3960
Phone
(970) 495-7421
Fax
(970) 495-7424
NPI assigned
Dec 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA051081 PA
Physician Assistant 363A00000X PA.0004675 CO Primary

Addresses

Primary practice location

1107 S Lemay Ave
Suite 240
Fort Collins, CO 80524-3960

Mailing address

1107 S Lemay Ave
Suite 240
Fort Collins, CO 80524-3960
Phone (970) 495-7421

Other identifiers 1

IdentifierTypeStateIssuer
31977839MedicaidCO

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
I20160817002901 CO Practitioner - Physician Assistant 3870485287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1024 S Lemay Ave
Fort Collins, CO 80524-3929

1107 S Lemay Ave
Unit 240 Uchmg Brain and Spine Fort Collin
Fort Collins, CO 80524-3959
Phone (970) 495-7420

1925 Mountain View Ave
Longmont, CO 80501-3128
Phone (303) 776-1234

2500 Rocky Mountain Ave
Loveland, CO 80538-9004

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

6767 29TH St
Greeley, CO 80634-5474
Phone (970) 224-3636

Hospital & facility affiliations

  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119
  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010
  • Uchealth Greeley Hospital Hospital, Greeley, CO, CCN 060131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0004675COMDPhysician Assistant
MA051081PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Aug 29, 2016 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Aug 29, 2016 Accepting new patients
Independent Apn, LLC Past Accepting new patients
Mercy Neurosurgery Group Past Accepting new patients
Bethany Hospice Services of Western Pennsylvania, LLC Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1107 S Lemay Ave
Ste 240
Fort Collins, CO 80524
Phone (970) 495-7420

2500 Rocky Mountain Ave
Ste 2300
Loveland, CO 80538
Phone (970) 203-7150

2500 Rocky Mountain Ave
Ste 340
Loveland, CO 80538
Phone (970) 495-7421

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 5

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1932184264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 S LEMAY AVE",
            "address_2": "SUITE 240",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243960",
            "telephone_number": "970-495-7421",
            "fax_number": "970-495-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 S LEMAY AVE",
            "address_2": "SUITE 240",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243960",
            "telephone_number": "970-495-7421",
            "fax_number": "970-495-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "ALLISON",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-09",
        "last_updated": "2016-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051081",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0004675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31977839",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.