=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851238240
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SMARTHEART MEDICINE, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/02/2026
-----------------------------------------------------
Last Update Date | 05/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2001 S SHIELDS ST STE F
-----------------------------------------------------
City | FORT COLLINS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80526-1833
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-239-9930
-----------------------------------------------------
Fax | 970-287-8800
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2001 S SHIELDS ST STE F
-----------------------------------------------------
City | FORT COLLINS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80526-1833
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-239-9930
-----------------------------------------------------
Fax | 970-287-8800
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | BETH JOHNSON
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 970-239-9930
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------