Individual provider Active NPI

John David Cranor, MD

  • Family Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1962516328
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26079 Issued in CO
Practice address
1124 E Elizabeth Street
Building C
Fort Collins, CO 80524-4051
Phone
(970) 484-0798
Fax
(970) 482-0679
NPI assigned
Aug 19, 2006
Last updated
Jul 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26079 CO Primary

Addresses

Primary practice location

1124 E Elizabeth Street
Building C
Fort Collins, CO 80524-4051

Mailing address

1124 E Elizabeth Street
Building C
Fort Collins, CO 80524-4051
Phone (970) 484-0798

Other identifiers 1

IdentifierTypeStateIssuer
01260793MedicaidCO

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100818000426 CO Practitioner - Family Practice 1254347842 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26079COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Health Care Inc. CurrentSince Nov 1, 2002 Accepting new patients
Poudre Valley Health Care Inc CurrentSince Nov 1, 2002 Accepting new patients
Complete Wellness Familly Medicine, PLLC Past Accepting new patients

Locations

1024 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 495-7000

1025 Pennock Pl
Fort Collins, CO 80524
Phone (970) 495-8800

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468368000000",
    "number": "1962516328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 E ELIZABETH STREET",
            "address_2": "BUILDING C",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244051",
            "telephone_number": "970-484-0798",
            "fax_number": "970-482-0679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 E ELIZABETH STREET",
            "address_2": "BUILDING C",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244051",
            "telephone_number": "970-484-0798",
            "fax_number": "970-482-0679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANOR",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "26079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01260793",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.