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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

BANNER HEALTH PHYSICIANS COLORADO LLC
NPI 1003763624
Clinic/Center - Multi-Specialty in Fort Collins, CO

Active since March 12, 2026CLIA Certified · 2 labs
4700 LADY MOON DR, FORT COLLINS, CO 80528(970) 821-4000(970) 821-4501 Get Directions Write a Review

NPPES record last updated: July 16, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 16, 2026, Mar 12, 2026 (2 updates tracked since 2026).

About Banner Health Physicians Colorado Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BANNER HEALTH PHYSICIANS COLORADO LLC (NPI 1003763624) is a healthcare organization registered as a multi-specialty in Fort Collins, Colorado and active in the NPI registry since March 2026. The organization holds 2 active CLIA laboratory certificates and lists Shiva Birdi, Ceo, as its authorized official.

NPPES Registry Identity

NPI1003763624
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameBANNER HEALTH PHYSICIANS COLORADO LLC
Location Address4700 LADY MOON DRFort Collins, CO 80528-4426
Mailing Address2901 N Central Ave Ste 160Phoenix, AZ 85012-2702 · (408) 768-3596
Phone(970) 821-4000
Fax(970) 821-4501
Organization SubpartYesParent: Banner Health
Authorized OfficialShiva BirdiCeo · (602) 747-4000
Enumeration DateMarch 12, 2026
Last NPPES UpdateJuly 16, 20262 updates tracked since enumeration
NPPES CertifiedJuly 16, 2026
✔ NPI 1003763624 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
4700 LADY MOON DR, Fort Collins, CO 80528
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CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 06D2090676

Banner Health Physicians Colorado, LLC · Fort Collins, CO
Active · expires Jan 27, 2027
CLIA Number06D2090676
Laboratory TypeCommunity Clinic
Certificate Effective DateJanuary 28, 2025
Certificate Expiration DateJanuary 27, 2027
Laboratory DirectorDr. Sarah Schutte
Laboratory Phone(970) 229-4500
Laboratory LocationBanner Health Physicians Colorado, LLC4700 Lady Moon Dr, Suite C1, Fort Collins, CO 80528
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Accreditation 06D2084806

Banner Health Dba Banner Fort Collins Medical Ctr · Fort Collins, CO
Active · expires May 24, 2028
CLIA Number06D2084806
Laboratory TypeHospital
Certificate Effective DateMay 25, 2026
Certificate Expiration DateMay 24, 2028
Laboratory DirectorDr. Harry W. Hamner
Laboratory Phone(970) 229-4000
Laboratory LocationBanner Health Dba Banner Fort Collins Medical Ctr4700 Lady Moon Dr, Fort Collins, CO 80528
CLIA data matches this NPI record on: Address
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KYMBERLEE ROYALS M.D.
Anesthesiology
4700 LADY MOON DR
FORT COLLINS, CO 80528
Larimer County (970) 420-0905
BANNER HEALTH
Ambulance
4700 LADY MOON DR
FORT COLLINS, CO 80528
Larimer County (970) 821-4000
DR. NICOLE BLYTHE MOORE RIEGER M.D.
Surgery
4700 LADY MOON DR
FORT COLLINS, CO 80528
Larimer County (970) 821-4000
BANNER ANESTHESIOLOGISTS COLORADO LLC
Clinic/Center (Multi-Specialty)
4700 LADY MOON DR
FORT COLLINS, CO 80528
Larimer County (970) 350-6399
BANNER HOSPITAL BASED PHYSICIANS COLORADO LLC
Clinic/Center (Multi-Specialty)
4700 LADY MOON DR
FORT COLLINS, CO 80528
Larimer County (970) 229-4500
DAVID JAMES LEVESQUE CRNA
Nurse Anesthetist, Certified Registered
4700 LADY MOON DR
FORT COLLINS, CO 80528
Larimer County (970) 821-4500
KRISTINA KINNEY CPNP
Nurse Practitioner (Pediatrics)
4700 LADY MOON DR
FORT COLLINS, CO 80528
Larimer County (970) 821-4000
BOBBI J CHAMBERS MD
Pediatrics
4700 LADY MOON DR
FORT COLLINS, CO 80528
Larimer County (970) 821-4000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Banner Health Physicians Colorado LLC's NPI number?

The NPI number for Banner Health Physicians Colorado LLC is 1003763624. It was assigned to this organization in the NPPES registry on March 12, 2026.

Where is Banner Health Physicians Colorado LLC located?

Banner Health Physicians Colorado LLC is located at 4700 Lady Moon Dr, Fort Collins, CO 80528. The listed phone number is (970) 821-4000.

What is Banner Health Physicians Colorado LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Banner Health Physicians Colorado LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Banner Health Physicians Colorado LLC was last updated on July 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.