FRONT RANGE CLINIC INC. (NPI# 1104342443) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104342443 |
| Entity Type | Organization |
| Organization Name | FRONT RANGE CLINIC INC. |
| Practice Address |
1308 Vivian St Longmont CO 80501-3217 |
| Mailing Address |
1040 E Elizabeth St Ste C Fort Collins CO 80524-3952 |
| Practice Telephone | 7205975576 |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2017-08-18 |
| Authorized Official Name | DR. CLARK MCCOY (PRESIDENT) |
| Authorized Official Telephone | 3522147180 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 0054001 | CO | Allopathic & Osteopathic Physicians |
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
0054001 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 1598135451 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356860803 | Front Range Clinic Inc. | Family Medicine | 1410 Vance St Ste 201, Lakewood, CO 80214-5435 | 2017-09-15 |
| 1275052722 | Front Range Clinic Inc. | Family Medicine | 1411 S Potomac St Ste 340, Aurora, CO 80012-4539 | 2017-09-15 |
| 1740706035 | Front Range Clinic Inc. | Family Medicine | 9025 Grant St Ste 101, Thornton, CO 80229-4362 | 2017-08-17 |
| 1598281875 | Front Range Clinic Inc. | Family Medicine | 3400 W 16th St Unit 1-dd, Greeley, CO 80634-6862 | 2017-08-17 |
| 1467963447 | Front Range Clinic Inc. | Counselor | 1040 E Elizabeth St Ste C, Fort Collins, CO 80524-3952 | 2017-10-18 |
| 1598135451 | Front Range Clinic Inc. | Family Medicine | 1040 E Elizabeth St, Suite C, Fort Collins, CO 80524-3951 | 2015-10-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Front Range Clinic Inc | 1040 E Elizabeth St Suite B, Fort Collins, CO 80524 |
| Street Address |
1308 VIVIAN ST |
| City | LONGMONT |
| State | CO |
| Zip Code | 80501-3217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508984709 | Mark Edward Babcock | Social Worker | 1308 Vivian St, Longmont, CO 80501-3217 | 2007-03-26 |
| 1386205888 | Samantha Gehring | Nurse Practitioner | 1308 Vivian St, Longmont, CO 80501-3217 | 2019-06-25 |
| 1609047430 | Haleh Nekoorad-long,m.d.,p.c. | Specialist | 1308 Vivian St, Longmont, CO 80501-3217 | 2008-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598376774 | Boulder County Public Health | Public Health or Welfare | 515 Coffman Street, Suite 200, Longmont, CO 80501 | 2020-08-12 |
| 1164032827 | Kidstuff Child and Family Counseling, P.C. | Marriage & Family Therapist | 360 15th Ave, Ste. 104, Longmont, CO 80501 | 2020-08-06 |
| 1861036501 | Stateserv Medical of Colorado | Durable Medical Equipment & Medical Supplies | 63 South Pratt Pkwy, Landmont, CO 80501 | 2019-11-06 |
| 1558915090 | Array Clinical and Therapeutic Services | Assistant Behavior Analyst | 451 21st Ave. Suite B, Longmont, CO 80501 | 2019-08-01 |
| 1275195042 | Alisa Marie Schwegerl | Speech-Language Pathologist | 1800 Stroh Place, Longmont, CO 80501 | 2019-07-02 |
| 1295298545 | Jovahna Pena | Counselor | Behavioral Health Group, 850 23rd Ave Unit A, Longmont, CO 80501 | 2019-04-12 |
| 1659845568 | University Physicians Incorporated | Advanced Practice Midwife | 2030 Mountain View Ave Ste 400, Longmont, CO 80501 | 2019-01-14 |
| 1013404714 | Crafted Physical Therapy Pllc | Physical Therapist | 701 Delaware Ave Unit E, Longmont, CO 80501 | 2018-04-18 |
| 1588110860 | Randall Bonnom | Counselor | 420 21st Ave #113, Longmont, CO 80501 | 2016-08-28 |
| 1225401771 | Sowash Optometry Group, PC | Eyewear Supplier (Equipment, not the service) | 1242 S. Hover Street, Suite C200, Longmont, CO 80501 | 2015-11-05 |
| Find all providers in zip 80501 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
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| 1235753948 | Haven Clinic | Family Medicine | 1150 N 25th St Ste D, Grand Junction, CO 81501-6561 | 2020-05-29 |
| 1528606795 | Denver Recovery Group LLC | Family Medicine | 2531 Airport Rd, Colorado Springs, CO 80910-3119 | 2019-12-18 |
| 1598312241 | Denver Recovery Group LLC | Family Medicine | 72 E Arapahoe Rd, Littleton, CO 80122-8001 | 2019-08-19 |
| 1912554668 | Denver Recovery Group LLC | Family Medicine | 5330 Manhattan Cir Ste H, Boulder, CO 80303-4240 | 2019-08-19 |
| 1639739097 | Bryan Clifford Handwork | Family Medicine | 3004 Arapahoe Ave, Boulder, CO 80303-1017 | 2019-06-18 |
| 1376949867 | Colorado Professional Recovery Inc. | Family Medicine | 4990 Kipling St, Suite B-5, Wheat Ridge, CO 80033-6762 | 2014-11-10 |
| 1548564545 | Michael Arthur Schwartz | Family Medicine | 2205 Cordillera Way, Edwards, CO 81632-6290 | 2011-01-05 |
| 1528374873 | Yvonne M Nelson Md Pllc | Family Medicine | 4487 W 107th Pl, Westminster, CO 80031-7603 | 2010-08-24 |
| 1437762481 | Julia Catherine Wells | Family Medicine | 1600 Fish Hatchery Rd, Estes Park, CO 80517-9227 | 2020-08-28 |
| Find all providers with the same taxonomy | ||||
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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.