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

Active since October 04, 2019CLIA Certified · 2 labs
4038 S TIMBERLINE RD UNIT 100, FORT COLLINS, CO 80525(970) 673-1155(970) 673-4747 Get Directions Write a Review

NPPES record last updated: June 30, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 30, 2020, Oct 4, 2019 (2 updates tracked since 2019).

About Front Range Dermatology Associates NPPES

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

FRONT RANGE DERMATOLOGY ASSOCIATES (NPI 1164063624) is a healthcare organization registered as a medical specialty in Fort Collins, Colorado and active in the NPI registry since October 2019. The organization holds 2 active CLIA laboratory certificates, maintains 3 additional practice locations, and lists Michele Blum, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1164063624
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameFRONT RANGE DERMATOLOGY ASSOCIATES
Location Address4038 S TIMBERLINE RD UNIT 100Fort Collins, CO 80525-6004
Mailing AddressPo Box 69Timnath, CO 80547-0069 · (970) 301-0130
Phone(970) 673-1155
Fax(970) 673-4747
Organization SubpartNo
Authorized OfficialMichele BlumPractice Manager · (970) 673-1155
Enumeration DateOctober 4, 2019
Last NPPES UpdateJune 30, 20202 updates tracked since enumeration
NPPES CertifiedJune 30, 2020
✔ NPI 1164063624 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
Definition
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).
4038 S TIMBERLINE RD UNIT 100, Fort Collins, CO 80525
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Secondary Practice Locations 3

Location 12923 Ginnala DrLoveland, CO 80538-2702 · Phone (970) 673-1155 · Fax (970) 673-4747
Location 2500 Main StFort Morgan, CO 80701-2130 · Phone (970) 673-1155 · Fax (970) 673-4747
Location 36801 W 20th St Unit 208Greeley, CO 80634-9640 · Phone (970) 301-0130 · Fax (970) 673-4747

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 of Compliance 06D2047363

Front Range Dermatology Associates · Greeley, CO
Active · expires Apr 17, 2027
CLIA Number06D2047363
Laboratory TypePhysician Office
Certificate Effective DateApril 18, 2025
Certificate Expiration DateApril 17, 2027
Laboratory DirectorDr. Aaron Z. Hoover
Laboratory Phone(970) 673-1155
Laboratory LocationFront Range Dermatology Associates6801 W 20th St, Ste 208, Greeley, CO 80634
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 06D2110085

Front Range Dermatology Associates · Fort Collins, CO
Active · expires Aug 24, 2026
CLIA Number06D2110085
Laboratory TypePhysician Office
Certificate Effective DateAugust 25, 2024
Certificate Expiration DateAugust 24, 2026
Laboratory DirectorDr. Joseph L. Wilde
Laboratory Phone(970) 673-1155
Laboratory LocationFront Range Dermatology Associates4038 Timberline Road, Suite 100, Fort Collins, CO 80525
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 2

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

ALLIE KAY PRESTON MD
Dermatology
4038 S TIMBERLINE RD UNIT 100
FORT COLLINS, CO 80525
Larimer County (970) 673-1155
MS. SARAH ELIZABETH HOCH PA-C
Physician Assistant (Medical)
4038 S TIMBERLINE RD UNIT 100
FORT COLLINS, CO 80525
Larimer County (970) 673-4747

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 Dermatology Associates's NPI number?

The NPI number for Front Range Dermatology Associates is 1164063624. It was assigned to this organization in the NPPES registry on October 4, 2019.

Where is Front Range Dermatology Associates located?

Front Range Dermatology Associates is located at 4038 S Timberline Rd Unit 100, Fort Collins, CO 80525. The listed phone number is (970) 673-1155.

What is Front Range Dermatology Associates's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Does Front Range Dermatology Associates 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 Front Range Dermatology Associates was last updated on June 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.