Provider Demographics
NPI:1851389613
Name:NORTHERN COLORADO ANESTHESIA PROFESSIONALS PLLC
Entity Type:Organization
Organization Name:NORTHERN COLORADO ANESTHESIA PROFESSIONALS PLLC
Other - Org Name:NCAP, PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOTOWEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-224-2985
Mailing Address - Street 1:3702 AUTOMATION WAY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5738
Mailing Address - Country:US
Mailing Address - Phone:970-224-2985
Mailing Address - Fax:970-223-1118
Practice Address - Street 1:3702 AUTOMATION WAY STE 103
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5738
Practice Address - Country:US
Practice Address - Phone:970-224-2985
Practice Address - Fax:970-223-1118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0225723OtherWORK COMP
CO04035054Medicaid
WY113844800Medicaid
CO187269700OtherFEDERAL WORK COMP
NEXX-XXXXXXX15Medicaid
NEXX-XXXXXXX15Medicaid
WYW24104Medicare PIN
CO04035054Medicaid
COC188008Medicare PIN