Provision Imaging Of Ft Collins
Clinic/Center, Radiology in Fort Collins, CO. Organization (NPI-2).
NPI number1457375545
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1457375545
- Entity type
- Organization (NPI-2)
- Legal business name
- Provision Imaging Of Ft Collins
- Organization subpart
- No
- Enumeration date
- Jul 26, 2006
- Last updated
- Aug 22, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0200X | Clinic/Center, Radiology | – | – | Yes |
Practice location
4114 Timberline RdFort Collins, CO 80525-6034
Phone 970-223-9939 · Fax 970-223-0273
Mailing address
1601 Nw ExpresswaySuite 1300
Oklahoma City, OK 73118
Phone 405-842-7768 · Fax 405-842-7789
Authorized official
Robert Matt Trent
Coo
4058427768
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