LANDREY FAGAN MD NPI 1548423817

NPI Information

  • NPI: 1548423817
  • Provider Name: LANDREY FAGAN, MD
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3434 47TH ST STE 225
    BOULDER, CO
    ZIP 80301
  • Phone: (720) 792-2852

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NPI Details

Landrey Fagan, MD is a family medicine in Boulder, CO with 18 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Landrey Fagan, MD NPI is 1548423817. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2008

The provider's business location address is:

3434 47TH ST STE 225
BOULDER, CO
ZIP 80301-880
Phone: (720) 792-2852
Fax: (303) 586-7592

The NPI 1548423817 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/8/2008 and was last updated on 12/3/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineDR0060345COLORADONo
2208M00000XHospitalistDR.0060345COLORADONo
3207Q00000XFamily MedicineDR.0060345COLORADOYes
4207Q00000XFamily Medicine246674MASSACHUSETTSNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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