FRONT RANGE DERMATOLOGY ASSOCIATES
NPI 1164063624
Clinic/Center - Medical Specialty in Fort Collins, CO

NPI Status: Active since October 04, 2019

Contact Information

4038 S TIMBERLINE RD UNIT 100
FORT COLLINS, CO
ZIP 80525
Phone: (970) 673-1155
Fax: (970) 673-4747

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  • Organization
  • Clinic/Center
  • Medical Specialty
  • CLIA Number: 06D2110085
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-24-2026

About FRONT RANGE DERMATOLOGY ASSOCIATES

This page provides the complete NPI Profile along with additional information for Front Range Dermatology Associates, a provider established in Fort Collins, Colorado operating as a Clinic/center, focusing in medical specialty . The healthcare provider is registered in the NPI registry with number 1164063624 assigned on October 2019. The practitioner's primary taxonomy code is 261QM2500X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is Michele Blum (Practice Manager)

NPI
1164063624
Provider Name
FRONT RANGE DERMATOLOGY ASSOCIATES
Entity Type
Organization
Location Address
4038 S TIMBERLINE RD UNIT 100 FORT COLLINS, CO 80525
Location Phone
(970) 673-1155
Location Fax
(970) 673-4747
Mailing Address
PO BOX 69 TIMNATH, CO 80547
Mailing Phone
(970) 301-0130
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-04-2019
Last Update Date
06-30-2020
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Location Map

Secondary Locations

  • 500 Main St
    Fort Morgan, CO 80701
    (970) 673-1155
  • 2923 Ginnala Dr
    Loveland, CO 80538
    (970) 673-1155
  • 6801 W 20th St Unit 208
    Greeley, CO 80634
    (970) 301-0130

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Medical Specialty

Taxonomy Code
261QM2500X
Type
Ambulatory Health Care Facilities
Taxonomy Description
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MICHELE BLUM

Authorized Official Title
PRACTICE MANAGER
Authorized Official Phone
(970) 673-1155

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
06D2110085
Facility Type
Physician Office
Certificate Effective Date
August 25, 2024
Certificate Expiration Date
August 24, 2026
Laboratory Director
DR. JOSEPH L. WILDE
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Front Range Dermatology Associates after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1164063624, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
4
Unchanged
Pos 5
0
Doubled → 0
Pos 6
6
Unchanged
Pos 7
3
Doubled → 6
Pos 8
6
Unchanged
Pos 9
2
Doubled → 4
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 0 → 0 3 → 6 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 2 + 4 + 0 + 6 + 6 + 6 + 4 + 24 = 56

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1164063624.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Physician Assistant (Medical)
4038 S TIMBERLINE RD UNIT 100
FORT COLLINS, CO 80525
Dermatology
4038 S TIMBERLINE RD UNIT 100
FORT COLLINS, CO 80525

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164063624, enumerated as an "organization" on October 04, 2019.

The provider is located at 4038 S TIMBERLINE RD UNIT 100 FORT COLLINS, CO 80525 and the phone number is (970) 673-1155.

Clinic/Center with taxonomy code 261QM2500X and a focus in Medical Specialty.