1. Home
  2. Directory
  3. Colorado
  4. Longmont
  5. Family Medicine
  6. NPI Profile

FRONT RANGE CLINIC INC.
NPI 1104342443
Family Medicine - Addiction Medicine in Longmont, CO

Active since August 18, 2017
1308 VIVIAN ST, LONGMONT, CO 80501(303) 834-8809 Get Directions Write a Review

NPPES record last updated: December 17, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 17, 2020, Aug 18, 2017 (2 updates tracked since 2017).

About Front Range Clinic Inc. NPPES

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

FRONT RANGE CLINIC INC. (NPI 1104342443) is a healthcare organization registered as an addiction medicine in Longmont, Colorado and active in the NPI registry since August 2017. The organization lists Clark Mccoy, President, as its authorized official.

NPPES Registry Identity

NPI1104342443
Entity TypeOrganization
Primary Taxonomy207QA0401X
Legal Business NameFRONT RANGE CLINIC INC.
Location Address1308 VIVIAN STLongmont, CO 80501-3217
Mailing Address1040 E Elizabeth St Ste CFort Collins, CO 80524-3952
Phone(303) 834-8809
Organization SubpartNo
Authorized OfficialClark MccoyPresident · (352) 214-7180
Enumeration DateAugust 18, 2017
Last NPPES UpdateDecember 17, 20202 updates tracked since enumeration
NPPES CertifiedDecember 17, 2020
✔ NPI 1104342443 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0401X
License✔ Licensed in CO · 0054001
Definition
A family medicine physician who specializes in the diagnosis and treatment of addictions.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 0054001 (CO)
1308 VIVIAN ST, Longmont, CO 80501
Open in Google Maps ↗

Other Identifiers 1

Medicaid1598135451CO

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

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

SUSAN GRAHAM PA
Physician Assistant
1308 VIVIAN ST
LONGMONT, CO 80501
Boulder County (800) 628-7828
SAMANTHA GEHRING FNP-C
Nurse Practitioner
1308 VIVIAN ST
LONGMONT, CO 80501
Boulder County (303) 834-8809
MARK EDWARD BABCOCK L.C.S.W.
Social Worker (Clinical)
1308 VIVIAN ST
LONGMONT, CO 80501
Boulder County (720) 635-0711
ROCKY MOUNTAIN CLINICS LLC
Family Medicine (Addiction Medicine)
1308 VIVIAN ST
LONGMONT, CO 80501
Boulder County (303) 834-8809
HALEH NEKOORAD-LONG,M.D.,P.C.
Specialist
1308 VIVIAN ST
LONGMONT, CO 80501
Boulder County (303) 682-9197

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 Front Range Clinic Inc.'s NPI number?

The NPI number for Front Range Clinic Inc. is 1104342443. It was assigned to this organization in the NPPES registry on August 18, 2017.

Where is Front Range Clinic Inc. located?

Front Range Clinic Inc. is located at 1308 Vivian St, Longmont, CO 80501. The listed phone number is (303) 834-8809.

What is Front Range Clinic Inc.'s specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Addiction Medicine, with taxonomy code 207QA0401X.

When was this NPI record last updated?

The NPPES record for Front Range Clinic Inc. was last updated on December 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.