DR. BRUCE RAYMOND BELLEVILLE (NPI# 1073670873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073670873 |
| Entity Type | Individual |
| Full Name | DR. BRUCE RAYMOND BELLEVILLE |
| Credential | M.D. |
| Practice Address |
2831 Skimmerhorn St Fort Collins CO 80526-6275 |
| Practice Telephone | 9702232274 |
| Mailing Telephone | 9702232274 |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2010-02-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0500X |
Preventive Medicine Specialization: Preventive Medicine/Occupational Environmental Medicine |
21657 | CO | Allopathic & Osteopathic Physicians |
| N | 2083P0500X |
Preventive Medicine Specialization: Preventive Medicine/Occupational Environmental Medicine |
9742 | MT | Allopathic & Osteopathic Physicians |
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
21657 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | WA L&I PROVIDER NUMBER | 150115 | 01 |
| CO | 01216571 | 05 |
| Street Address |
2831 SKIMMERHORN ST |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80526-6275 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619206638 | Bruce R. Belleville, Md, LLC | Pain Medicine | 2831 Skimmerhorn St, Fort Collins, CO 80526-6275 | 2009-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831736057 | Jade Elaine Tilley | Behavior Technician | 3005 Ross Drive Apt V #21, Fort Collins, CO 80526 | 2019-12-06 |
| 1073179131 | Jana Marie Carson | Marriage & Family Therapist | 2001 S. Shields St. Bld K, Ft. Collins, CO 80526 | 2019-05-14 |
| 1467922443 | Marshall Hannum | Occupational Therapist | 2312 Limousin Ct., Fort Collins, CO 80526 | 2018-12-03 |
| 1205326634 | Marlene A Baczek | Acupuncturist | 2001 S. Shields, Bldg B, Ste 2, Fort Collins, CO 80526 | 2018-05-10 |
| 1164922852 | James Joseph Reid | Social Worker | 831 Benthaven St., Ft. Collins, CO 80526 | 2018-02-19 |
| 1982113718 | Friends of L'arche Fort Collins | Community/Behavioral Health | 4500 Seneca St Unit 71, Fort Collins, CO 80526 | 2017-09-25 |
| 1578004313 | Jenessa Dyke | Chiropractor | 2531 S Shields St # 2j-h, Fort Collins, CO 80526 | 2017-03-13 |
| 1588102388 | Sarah Klein | Counselor | 1301 Glen Haven Dr, Fort Collins, CO 80526 | 2017-02-01 |
| 1972046530 | Benu Amun-ra | Non-emergency Medical Transport (VAN) | 4779 Skyline Dr, Ft. Collins, CO 80526 | 2016-11-29 |
| 1205280328 | Abigail Depperschmidt | Physical Therapist | 940 Worthington Circle, Fort Collins, CO 80526 | 2016-04-14 |
| Find all providers in zip 80526 | ||||
| Taxonomy Code | 2083P0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Preventive Medicine/Occupational Environmental Medicine |
| A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083005789 | Healthstat Onsite Clinic Nbb | Preventive Medicine | 702 W Drake Rd, Suite 702 A, Fort Collins, CO 80526-5556 | 2015-02-17 |
| 1114365947 | Healthstat On-site Clinic/larimer County | Preventive Medicine | 2310 E Prospect Rd, Suite D, Fort Collins, CO 80525-9770 | 2013-06-14 |
| 1205980463 | Brian James Thompson | Preventive Medicine | 620 S Lemay Ave, Fort Collins, CO 80524-3543 | 2007-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336750942 | Healthstat Inc Reo | Preventive Medicine | 5505 Airport Blvd, Boulder, CO 80301-2316 | 2020-08-17 |
| 1205464757 | Healthstat Onsite Hss | Preventive Medicine | 990 S Broadway Ste 100, Denver, CO 80209-4084 | 2020-03-31 |
| 1356866511 | John Taylor Morrison | Preventive Medicine | 1065 S High St, Denver, CO 80209-4552 | 2017-08-09 |
| 1194172551 | Alfred Sellers | Preventive Medicine | 1105 Garlock Ln, Colorado Springs, CO 80918-3117 | 2016-05-16 |
| 1629417373 | Healthstat On-site Clinic/city of Loveland | Preventive Medicine | 1632 Topaz Ln, Loveland, CO 80537 | 2013-06-17 |
| 1376893966 | Healthstat- Steamboat Springs School District | Preventive Medicine | 325 7th St., Steamboat Springs, CO 80487 | 2012-09-12 |
| 1679800494 | Alisa Koval | Preventive Medicine | 1400 Jackson St., Denver, CO 80206 | 2009-11-16 |
| 1699924415 | James Philip Kornberg | Preventive Medicine | 12665 Highway 62, Ridgway, CO 81432 | 2008-09-17 |
| 1215105093 | Anthony Suruda | Preventive Medicine | 969 Reese Street, Silverton, CO 81433-0850 | 2008-02-14 |
| 1952422446 | Mark Norman Frank | Preventive Medicine | 3820 Barr Ct, Boulder, CO 80305-6503 | 2007-04-02 |
| Find all providers with the same taxonomy | ||||
| City | FORT COLLINS |
| Zip Code | 80526 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.