MADISON STREET PROVIDER NETWORK INC (NPI# 1154928331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154928331 |
| Entity Type | Organization |
| Organization Name | MADISON STREET PROVIDER NETWORK INC |
| Practice Address |
4103 Boardwalk Dr Unit 100 Fort Collins CO 80525-5933 |
| Mailing Address |
Po Box 912914 Denver CO 80291-2914 |
| Practice Telephone | 3033938565 |
| Practice Fax Number | 3033772022 |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2020-10-01 |
| Authorized Official Name | GEORGE L NEAL (PRESIDENT) |
| Authorized Official Telephone | 4692140144 |
| Is Organization Subpart | Y |
| Parent Organization Name | MADISON STREET PROVIDER NETWORK INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Omni Eye Specialists | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750988994 | Madison Street Provider Network Inc | Ophthalmology | 606 South 4th Ave, Marchus Chiropractic Medical Office, Brighton, CO 80601-3202 | 2020-10-01 |
| 1033716212 | Madison Street Provider Network Inc | Optometrist | 1371 Hecla Dr Ste C, Louisville, CO 80027-2318 | 2020-10-01 |
| 1831796010 | Madison Street Provider Network Inc | Optometrist | 10001 N. Washington St., Thornton, CO 80229-2050 | 2020-10-01 |
| 1699768663 | Madison Street Provider Network Inc | Optometrist | 55 Madison St Ste 355, Denver, CO 80206-5429 | 2005-08-25 |
| 1194323444 | Madison Street Provider Network Inc | Optometrist | 55 Madison St Ste 355, Denver, CO 80206-5429 | 2020-10-09 |
| 1063019214 | Madison Street Provider Network Inc | Optometrist | 6881 S Yosemite St, Centennial, CO 80112-1406 | 2020-10-01 |
| Street Address |
4103 BOARDWALK DR UNIT 100 |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80525-5933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356950299 | Kelly Westbrook Schmalstich | Clinical Nurse Specialist | 2020 Blue Yonder Way, Fort Collins, CO 80525 | 2020-07-27 |
| 1912522376 | Tender Gifts Midwifery and Birth Center | Clinical Nurse Specialist | 1817 Jessup Dr Farms, Fort Collins, CO 80525 | 2020-06-11 |
| 1114566015 | Andrea Nicole Brogdon | Acupuncturist | 2501 S. College Ave, Fort Collins, CO 80525 | 2019-12-26 |
| 1013553593 | Kids Overcoming, LLC | Home Health | 1330 Oakridge Drive Suite 105, Fort Collins, CO 80525 | 2019-11-20 |
| 1568019966 | Julia Heithoff | Behavioral Analyst | 1100 Haxton Dr #115, Fort Collins, CO 80525 | 2019-08-20 |
| 1144875246 | Harmony Smiles Dentistry, LLP | Dentist | 356 E Harmony Rd., #6-a, Fort Collins, CO 80525 | 2019-08-06 |
| 1841774502 | Shannon L Harris | Social Worker | 305 Carpenter Road, Fort Collins, CO 80525 | 2018-09-19 |
| 1306332101 | Joshua Evans Brooks | Optometrist | 375 E Horsetooth Rd Bldg 5 Ste 201, Fort Collins, CO 80525 | 2018-07-03 |
| 1285120212 | Danae Fuqua | Physical Medicine & Rehabilitation | Covell Care & Rehabilitation, 2350 Limon Dr., Fort Collins, CO 80525 | 2018-07-02 |
| 1528552890 | Megan E Locke | Audiologist | 724 Whalers Way Bdg I, Suite 101, Fort Collins, CO 80525 | 2018-06-19 |
| Find all providers in zip 80525 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093262024 | Laser Vision of Fort Collins | Ophthalmology | 3617 S College Ave Unit C, Fort Collins, CO 80525-3009 | 2016-09-07 |
| 1023307048 | Joshua Yale Apple | Ophthalmology | 3151 Precision Dr, Fort Collins, CO 80528-4601 | 2011-03-30 |
| 1598982902 | Laryssa R Dragan | Ophthalmology | 2014 Caribou Dr Ste 150, Fort Collins, CO 80525-4373 | 2007-04-19 |
| 1518971233 | Ronald Bert Frenkel | Ophthalmology | 8475 Shamrock Ranch Rd, Fort Collins, CO 80524-3299 | 2006-07-28 |
| 1609872068 | William A Shachtman | Ophthalmology | 1725 E Prospect Road, Fort Collins, CO 80525-1307 | 2005-06-21 |
| 1346243714 | Kent Paris Bashford | Ophthalmology | 1725 E Prospect Rd, Fort Collins, CO 80525-1307 | 2005-05-31 |
| 1427051671 | Jennifer P Logan | Ophthalmology | 6715 Antigua Dr, Fort Collins, CO 80525-9433 | 2005-05-23 |
| 1336429158 | Jennifer Logan, M.d., LLC | Ophthalmology | 6715 Antigua Dr, Fort Collins, CO 80525-9433 | 2011-08-24 |
| 1679860225 | Matthew Ken Asano | Ophthalmology | 3151 Precision Dr, Fort Collins, CO 80528-4601 | 2011-07-05 |
| 1245467117 | John Adam Mclaughlin | Ophthalmology | 1725 E Prospect Rd, Fort Collins, CO 80525-1307 | 2009-06-17 |
| Find all providers in FORT COLLINS | ||||
| City | FORT COLLINS |
| Zip Code | 80525 |
Please comment or provide details below to improve the information on MADISON STREET PROVIDER NETWORK INC.
| 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.