BENDER MEDICAL GROUP, INC (NPI# 1619421351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619421351 |
| Entity Type | Organization |
| Organization Name | BENDER MEDICAL GROUP, INC |
| Other Organization Name | MIRAMONT FAMILY MEDICINE |
| Practice Address |
313 W Drake Rd Fort Collins CO 80526-2846 |
| Mailing Address |
4674 Snow Mesa Dr Ste 140 Fort Collins CO 80528-8614 |
| Practice Telephone | 9704828881 |
| Practice Fax Number | 9704829646 |
| Mailing Telephone | 9702255107 |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2016-08-11 |
| Authorized Official Name | JULIE M DESAIRE (CHIEF BUSINESS DEVELOPMENT OFFICER) |
| Authorized Official Telephone | 9702255107 |
| Is Organization Subpart | Y |
| Parent Organization Name | BENDER MEDICAL GROUP, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Miramont Family Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033660931 | Bender Medical Group, Inc | Dental Hygienist | 313 W Drake Rd, Fort Collins, CO 80526 | 2016-10-17 |
| 1669773263 | Bender Medical Group, Inc | Family Medicine | 168 Main St, Red Feather Lakes, CO 80545 | 2010-11-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | BENDER MEDICAL GROUP, INC. | Miramont Family Medicine, 4674 Snow Mesa Drive Ste 140, Fort Collins, CO 80528 |
| Street Address |
313 W DRAKE RD |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80526-2846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811989064 | Douglas Bruce Deyoung | Family Medicine | 313 W Drake Rd, Fort Collins, CO 80526-2846 | 2005-08-15 |
| 1821613878 | Advanced Foot Care, PC | Podiatrist | 313 W Drake Rd, Fort Collins, CO 80526-2846 | 2020-06-15 |
| 1063041374 | Radiant Dental Health | Clinic/Center | 313 W Drake Rd, Fort Collins, CO 80526-2846 | 2020-04-07 |
| 1285179572 | Natural Health Associates LLC | Massage Therapist | 313 W Drake Rd, Suite 210, Fort Collins, CO 80526-2846 | 2016-12-22 |
| 1033660931 | Bender Medical Group, Inc | Dental Hygienist | 313 W Drake Rd, Fort Collins, CO 80526 | 2016-10-17 |
| 1134580806 | Savannah Russell | Acupuncturist | 313 W Drake Rd, Suite 210, Fort Collins, CO 80526-2846 | 2016-03-09 |
| 1659751980 | Douglas William Bermingham | Psychologist | 313 W Drake Rd, Fort Collins, CO 80526-2846 | 2015-06-02 |
| 1679912919 | Bender Medical Group | Family Medicine | 313 W Drake Rd, Fort Collins, CO 80526-2846 | 2013-06-20 |
| 1740596527 | Bender Medical Group | Family Medicine | 313 W Drake Rd, Fort Collins, CO 80526-2846 | 2010-08-31 |
| 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 | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164935938 | Allison Jung Family Dentistry, Pllc | Clinic/Center | 1927 Wilmington Dr Unit 202, Fort Collins, CO 80528-6102 | 2017-11-14 |
| 1346679321 | Mod LLC | Clinic/Center | 2121 Midpoint Dr, Suite 102, Fort Collins, CO 80525-4339 | 2013-11-11 |
| 1821092495 | Health Services District of Northern Larimer County | Clinic/Center | 120 Bristlecone Dr, Fort Collins, CO 80524-2031 | 2005-06-10 |
| 1073129912 | Health Services District of Northern Larimer County | Clinic/Center | 202 Bristlecone Dr, Fort Collins, CO 80524-2031 | 2020-09-16 |
| 1063041374 | Radiant Dental Health | Clinic/Center | 313 W Drake Rd, Fort Collins, CO 80526-2846 | 2020-04-07 |
| 1891274122 | Timberline Orthodontics, Pllc | Clinic/Center | 1424 E Horsetooth Rd Ste 1, Fort Collins, CO 80525-5726 | 2018-08-08 |
| 1417486481 | Kimball Endodontics | Clinic/Center | 1331 E Prospect Rd Unit B1, Fort Collins, CO 80525-1367 | 2017-06-05 |
| 1356723571 | Cary W. Sanders, D.d.s., P.C. | Clinic/Center | 2000 Vermont Dr, Suite 200, Fort Collins, CO 80525-2900 | 2015-06-24 |
| 1932478336 | Tooth Fairys, P.C. | Clinic/Center | 373 W Drake Rd, Fort Collins, CO 80526-2881 | 2011-12-14 |
| 1710282793 | Absolute Dental, P.C. | Clinic/Center | 1015 S Taft Hill Rd, Fort Collins, CO 80521-4240 | 2011-01-21 |
| Find all providers in FORT COLLINS | ||||
| 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.