| Rocky Mountain Neurodiagnostics | |
|
1511 Onyx Cir Longmont CO 80504-7805 | |
| (303) 776-5298 | |
| (303) 682-2785 |
| Full Name | Rocky Mountain Neurodiagnostics |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1511 Onyx Cir, Longmont, Colorado |
| Authorized Official Name and Position | Kia Churchwell (PAYER CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 6159330792 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rocky Mountain Neurodiagnostics 1511 Onyx Cir Longmont CO 80504-7805 Ph: (303) 776-5298 | Rocky Mountain Neurodiagnostics 1511 Onyx Cir Longmont CO 80504-7805 Ph: (303) 776-5298 |
| NPI Number | 1659640381 |
|---|---|
| Provider Enumeration Date | 12/27/2011 |
| Last Update Date | 07/10/2024 |
| Certification Date | 07/10/2024 |
| Medicare PECOS PAC ID | 2860734597 |
|---|---|
| Medicare Enrollment ID | O20190430000984 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659640381 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | 30103 (Colorado) | Primary |
| Provider Name | Bruce A Katuna |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073615704 PECOS PAC ID: 0143127373 Enrollment ID: I20031216000765 |
| Provider Name | Badreldin Ibrahim |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295726453 PECOS PAC ID: 7315997491 Enrollment ID: I20150804003098 |
| Provider Name | Craig Carroll |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861479628 PECOS PAC ID: 7012148596 Enrollment ID: I20160315001835 |
| Provider Name | Grant M Warmouth |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1376757344 PECOS PAC ID: 3476687658 Enrollment ID: I20180112000221 |
| Provider Name | Barbara Anne Landesman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043345861 PECOS PAC ID: 8729184809 Enrollment ID: I20180710003628 |
| Provider Name | Yvan Rodrigues |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487973103 PECOS PAC ID: 5890980114 Enrollment ID: I20210209001540 |
| Provider Name | Francisco Vega-bermudez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528005485 PECOS PAC ID: 8123923877 Enrollment ID: I20210223001926 |
| Provider Name | Alendia Hartshorn |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275707978 PECOS PAC ID: 3779727680 Enrollment ID: I20211001000938 |
| Provider Name | Melissa Thomas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730330176 PECOS PAC ID: 9234290750 Enrollment ID: I20211006000438 |
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