JOHN C WILDE (NPI# 1245631712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245631712 |
| Entity Type | Individual |
| Full Name | JOHN C WILDE |
| Credential | MA, LAC |
| Practice Address |
125 Crestridge St Fort Collins CO 80525-3934 |
| Practice Telephone | 9704949761 |
| Mailing Telephone | 9704949761 |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2014-09-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
ACD.0000026 | CO | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265501316 | John A Wilde | Dentist | 1626 Morgan St, Suite 3, Keokuk, IA 52632 | 2006-11-06 |
| 1932620630 | John Wilde | Student in an Organized Health Care Education/Training Program | 147 N Brent St, Atten: Gme, Ventura, CA 93003 | 2017-07-03 |
| Street Address |
125 CRESTRIDGE ST |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80525-3934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447219449 | Summitstone Health Partners | Clinic/Center | 125 Crestridge St, Fort Collins, CO 80525-3934 | 2006-03-20 |
| 1851990139 | Cheryl Jacqueline Klein | Community/Behavioral Health | 125 Crestridge St, Fort Collins, CO 80525-4371 | 2020-10-19 |
| 1497291165 | Shanon Aurora Staires | Case Manager/Care Coordinator | 125 Crestridge St, Fort Collins, CO 80525-3934 | 2017-01-18 |
| 1144765835 | Sarah Copeland | Registered Nurse | 125 Crestridge St, Fort Collins, CO 80525-3934 | 2017-01-04 |
| 1902340185 | Megan Demo | Social Worker | 125 Crestridge St, Fort Collins, CO 80525-3934 | 2016-12-07 |
| 1316496201 | Samuel Leonard | Case Manager/Care Coordinator | 125 Crestridge St, Fort Collins, CO 80525-3934 | 2016-10-03 |
| 1538618871 | Diana Retherford | Case Manager/Care Coordinator | 125 Crestridge St, Fort Collins, CO 80525-3934 | 2016-09-28 |
| 1083162036 | Colby Miller | Case Manager/Care Coordinator | 125 Crestridge St, Fort Collins, CO 80525-3934 | 2016-09-20 |
| 1265980635 | Julie Harris | Case Manager/Care Coordinator | 125 Crestridge St, Fort Collins, CO 80525-3934 | 2016-09-14 |
| 1841747680 | Cody Cummings | Case Manager/Care Coordinator | 125 Crestridge St, Fort Collins, CO 80525-3934 | 2016-09-09 |
| Find all providers in the same location | ||||
| 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 | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609497379 | Vance Allen Hansen | Counselor | 203 W Myrtle St Apt C, Fort Collins, CO 80521-2822 | 2020-05-04 |
| 1780233874 | Hygieia Wellness | Counselor | 311 E Mulberry St Ste H, Fort Collins, CO 80524-3193 | 2019-09-10 |
| 1669034096 | Jeffrey M Graff | Counselor | 363 W Drake Rd Ste 8, Fort Collins, CO 80526-2882 | 2019-07-06 |
| 1912380130 | Crystal Vessels | Counselor | 1008 Patton St, Fort Collins, CO 80524 | 2015-07-07 |
| 1710379334 | Kay Kimball | Counselor | 2609 W Vine Dr, Fort Collins, CO 80521-1505 | 2015-02-19 |
| 1609207604 | George Bishop | Counselor | 1020 Country Club Rd, Fort Collins, CO 80524-1818 | 2013-12-02 |
| 1699105783 | Debra Paulison | Counselor | 1612 Lakeshore Dr, Fort Collins, CO 80525-2421 | 2013-11-26 |
| 1144650359 | Patricia Albano Cochran | Counselor | 1930 Constitution Ave, Fort Collins, CO 80526-1504 | 2013-11-25 |
| 1043640501 | Donna Betschowa | Counselor | 301 Spaulding Ln Lot 15, Fort Collins, CO 80524-1858 | 2013-11-20 |
| 1023444130 | Jennifer L Wayman | Counselor | 1412 Ottawa Ct, Fort Collins, CO 80526-2598 | 2013-09-20 |
| Find all providers in FORT COLLINS | ||||
| City | FORT COLLINS |
| Zip Code | 80525 |
Please comment or provide details below to improve the information on JOHN C WILDE.
| 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.