| Banner Hospital Based Physicians Colorado Llc | |
|
5890 W 13th St Ste 104 Greeley CO 80634-4821 | |
| (970) 392-2135 | |
| (970) 378-3825 |
| Full Name | Banner Hospital Based Physicians Colorado Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5890 W 13th St, Greeley, Colorado |
| Authorized Official Name and Position | Dennis Dahlen (SR VP FINANCE) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner Hospital Based Physicians Colorado Llc 1441 N 12th St Phoenix AZ 85006-2837 Ph: () - | Banner Hospital Based Physicians Colorado Llc 5890 W 13th St Ste 104 Greeley CO 80634-4821 Ph: (970) 392-2135 |
| NPI Number | 1821336769 |
|---|---|
| Provider Enumeration Date | 01/28/2013 |
| Last Update Date | 01/28/2013 |
| Medicare PECOS PAC ID | 6800031386 |
|---|---|
| Medicare Enrollment ID | O20130404000393 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821336769 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Julie A Gaca |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1013946672 PECOS PAC ID: 6507759727 Enrollment ID: I20040203000492 |
| Provider Name | Robert R Dillon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629119383 PECOS PAC ID: 2567355480 Enrollment ID: I20040204001076 |
| Provider Name | Marcus R Reinhardt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356349823 PECOS PAC ID: 7618860172 Enrollment ID: I20040206000777 |
| Provider Name | Jay F Cook |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871576520 PECOS PAC ID: 5890688477 Enrollment ID: I20040209000330 |
| Provider Name | Grant M Taylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417963349 PECOS PAC ID: 4082501242 Enrollment ID: I20040302000829 |
| Provider Name | Tesfaye Demeke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255352217 PECOS PAC ID: 6507756483 Enrollment ID: I20040421001333 |
| Provider Name | Thomas M Blomquist |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215996178 PECOS PAC ID: 8921095266 Enrollment ID: I20040428000747 |
| Provider Name | Kenneth Richards |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1083689376 PECOS PAC ID: 5698752707 Enrollment ID: I20040706001132 |
| Provider Name | David P Schnur |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1669442208 PECOS PAC ID: 5496725152 Enrollment ID: I20040729000628 |
| Provider Name | Pamola Gale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447250071 PECOS PAC ID: 4880662030 Enrollment ID: I20040924000297 |
| Provider Name | Scott J Schaffer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750364931 PECOS PAC ID: 0143289660 Enrollment ID: I20041008000709 |
| Provider Name | Gary W Bauerle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033129267 PECOS PAC ID: 9830151216 Enrollment ID: I20041028000386 |
| Provider Name | James Wolach |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1881673820 PECOS PAC ID: 3173586641 Enrollment ID: I20041105000258 |
| Provider Name | Janna G Deason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770568768 PECOS PAC ID: 2961450499 Enrollment ID: I20050111000481 |
| Provider Name | Fred Severyn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831208180 PECOS PAC ID: 7618927716 Enrollment ID: I20050126000899 |
| Provider Name | Samuel A Shelanski |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1295713899 PECOS PAC ID: 2163483652 Enrollment ID: I20050302000558 |
| Provider Name | Mark E Howshar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891710547 PECOS PAC ID: 9133026248 Enrollment ID: I20050411000444 |
| Provider Name | Edward C Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366425803 PECOS PAC ID: 5193762185 Enrollment ID: I20050412000153 |
| Provider Name | Stephen H Shogan |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1801982400 PECOS PAC ID: 9931147188 Enrollment ID: I20050419001162 |
| Provider Name | Harlan Harclerode |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316966781 PECOS PAC ID: 6204734015 Enrollment ID: I20050726000543 |
| Provider Name | Chima C Nwizu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902882517 PECOS PAC ID: 7214962554 Enrollment ID: I20051005000663 |
| Provider Name | Dena S Sheppard Madden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841249968 PECOS PAC ID: 9133142003 Enrollment ID: I20060105000713 |
| Provider Name | Robert A Mason |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821005992 PECOS PAC ID: 7911920244 Enrollment ID: I20060112000418 |
| Provider Name | Robert C Bruce |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922098292 PECOS PAC ID: 4981619012 Enrollment ID: I20060210000546 |
| Provider Name | Sherri A Barzdukas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386726198 PECOS PAC ID: 3173533098 Enrollment ID: I20060421000313 |
| Provider Name | Kelly R Sanderford |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790730562 PECOS PAC ID: 5890757355 Enrollment ID: I20060822000167 |
| Provider Name | Christopher S Michael |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1689607491 PECOS PAC ID: 5496858631 Enrollment ID: I20070308000588 |
| Provider Name | Daphne Rommereim Madden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740287556 PECOS PAC ID: 6709980287 Enrollment ID: I20070323000162 |
| Provider Name | Maurice I Lyons |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386610194 PECOS PAC ID: 2961503743 Enrollment ID: I20070724000122 |
| Provider Name | Christopher Erickson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477647261 PECOS PAC ID: 2264525161 Enrollment ID: I20070910000202 |
| Provider Name | Randall C Marsh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1720042161 PECOS PAC ID: 3274426564 Enrollment ID: I20071011000561 |
| Provider Name | Curtis E Crylen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1881644532 PECOS PAC ID: 3678637543 Enrollment ID: I20090122000150 |
| Provider Name | John Thieszen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285667816 PECOS PAC ID: 8325105109 Enrollment ID: I20090323000263 |
| Provider Name | Steven W Loecke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265410005 PECOS PAC ID: 5890841779 Enrollment ID: I20090917000333 |
| Provider Name | Helene Christner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649400052 PECOS PAC ID: 9638225006 Enrollment ID: I20090928000039 |
| Provider Name | Wayne S Jeffers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952390114 PECOS PAC ID: 5597802728 Enrollment ID: I20091021000168 |
| Provider Name | Shu Zhang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326257387 PECOS PAC ID: 8527119783 Enrollment ID: I20091021000183 |
| Provider Name | Angela M Mills |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215152954 PECOS PAC ID: 2466592266 Enrollment ID: I20091229000232 |
| Provider Name | Myka D Fisher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154558302 PECOS PAC ID: 5991846875 Enrollment ID: I20100114000425 |
| Provider Name | Roland K Kafuuma |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962615732 PECOS PAC ID: 3072681709 Enrollment ID: I20100811000418 |
| Provider Name | David C Puls |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982800835 PECOS PAC ID: 7113041252 Enrollment ID: I20100826000684 |
| Provider Name | Amy E Mattox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386840239 PECOS PAC ID: 4385768274 Enrollment ID: I20100830000401 |
| Provider Name | Jonathan Alex Kary |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811982788 PECOS PAC ID: 3870627243 Enrollment ID: I20100902000979 |
| Provider Name | Matthew Leonard Martinez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881669703 PECOS PAC ID: 8426148511 Enrollment ID: I20100916001275 |
| Provider Name | Joanna Humphrey Branum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033184957 PECOS PAC ID: 0446340533 Enrollment ID: I20101004000357 |
| Provider Name | Samuel L Saltz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609049287 PECOS PAC ID: 2769674407 Enrollment ID: I20101013000273 |
| Provider Name | Mckay C Marler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629163183 PECOS PAC ID: 4385838366 Enrollment ID: I20101103001024 |
| Provider Name | Daniel Heaston |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1871715078 PECOS PAC ID: 1658426580 Enrollment ID: I20101123000778 |
| Provider Name | Lynn J Boyce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831329341 PECOS PAC ID: 3577751981 Enrollment ID: I20101229001136 |
| Provider Name | Bradford R Keeler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1669431946 PECOS PAC ID: 1456428614 Enrollment ID: I20110104000862 |
| Provider Name | Justin J Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871799726 PECOS PAC ID: 5698955912 Enrollment ID: I20110203000653 |
| Provider Name | Courtney B Isley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366601700 PECOS PAC ID: 4183897176 Enrollment ID: I20111108000642 |
| Provider Name | Keith L Elliott |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1508011180 PECOS PAC ID: 5597933911 Enrollment ID: I20120228000565 |
| Provider Name | Stephen J Frank |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1013991736 PECOS PAC ID: 3173787272 Enrollment ID: I20120620000482 |
| Provider Name | Cara Bruntz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194089425 PECOS PAC ID: 4385800218 Enrollment ID: I20120723000236 |
| Provider Name | Eugene J Reinersman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003138397 PECOS PAC ID: 5799961546 Enrollment ID: I20130201000405 |
| Provider Name | Marvin Couch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023031861 PECOS PAC ID: 1153352166 Enrollment ID: I20130930000108 |
| Provider Name | Michelle Myers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881774289 PECOS PAC ID: 2567508211 Enrollment ID: I20131113000773 |
| Provider Name | Molly E Decker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194972091 PECOS PAC ID: 2365693595 Enrollment ID: I20131220000719 |
| Provider Name | Brandon M Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144570763 PECOS PAC ID: 6709037526 Enrollment ID: I20131227000478 |
| Provider Name | Ryan E Peck |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902118813 PECOS PAC ID: 4981842150 Enrollment ID: I20140115001490 |
| Provider Name | William Ketcham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184668857 PECOS PAC ID: 6002005808 Enrollment ID: I20140325000931 |
| Provider Name | William Lefler |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1023235058 PECOS PAC ID: 8325172711 Enrollment ID: I20140826002259 |
| Provider Name | John Herbert Borkert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699033951 PECOS PAC ID: 1951526151 Enrollment ID: I20140911002144 |
| Provider Name | Matthew Remakus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790911683 PECOS PAC ID: 0749437846 Enrollment ID: I20140915001570 |
| Provider Name | Nicolas C Knauss |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447540307 PECOS PAC ID: 5294968996 Enrollment ID: I20140915002277 |
| Provider Name | Matthew Measel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851594188 PECOS PAC ID: 5193993483 Enrollment ID: I20141003000163 |
| Provider Name | Heather A Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770819922 PECOS PAC ID: 3173651031 Enrollment ID: I20141117000543 |
| Provider Name | Miguel S Ruelas-salgado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760663553 PECOS PAC ID: 2365621646 Enrollment ID: I20150225002128 |
| Provider Name | Richard A Bertelsen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427153766 PECOS PAC ID: 8527026855 Enrollment ID: I20150810001560 |
| Provider Name | Leo A Soehnlen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972868131 PECOS PAC ID: 2961719679 Enrollment ID: I20150914000566 |
| Provider Name | Jaime L Cazer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639541550 PECOS PAC ID: 4587965694 Enrollment ID: I20151215000893 |
| Provider Name | Ahmed Awais |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1225366628 PECOS PAC ID: 2860662939 Enrollment ID: I20160108000972 |
| Provider Name | Ellie A Westover |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922366616 PECOS PAC ID: 4486888021 Enrollment ID: I20160610000470 |
| Provider Name | Rachel M Koch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033554951 PECOS PAC ID: 9830492644 Enrollment ID: I20160707002137 |
| Provider Name | Nicole D Valencia |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1548664980 PECOS PAC ID: 3971829706 Enrollment ID: I20161212000253 |
| Provider Name | Kyle Hirsh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356778161 PECOS PAC ID: 4981823580 Enrollment ID: I20170112001299 |
| Provider Name | Esther L Mondo |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1073838462 PECOS PAC ID: 9638451925 Enrollment ID: I20170120002694 |
| Provider Name | Kindra R Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689118440 PECOS PAC ID: 1850668021 Enrollment ID: I20170519000637 |
| Provider Name | John David Cowden |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1982665071 PECOS PAC ID: 1951204064 Enrollment ID: I20170525002522 |
| Provider Name | Steven D Rankin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265471858 PECOS PAC ID: 1951376987 Enrollment ID: I20170602000502 |
| Provider Name | Elizabeth M Holl |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730447939 PECOS PAC ID: 9931406584 Enrollment ID: I20170711001515 |
| Provider Name | Anuja J Riles |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366717761 PECOS PAC ID: 1850607276 Enrollment ID: I20170807002240 |
| Provider Name | Nicole M Matthews |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043621410 PECOS PAC ID: 9931329091 Enrollment ID: I20170810000670 |
| Provider Name | Urszula H Kotlow |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871692178 PECOS PAC ID: 2062481252 Enrollment ID: I20171024003544 |
| Provider Name | Robin A Lacour |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1548448442 PECOS PAC ID: 1355414442 Enrollment ID: I20171208000341 |
| Provider Name | Jeffrey L Tyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699155010 PECOS PAC ID: 1153688643 Enrollment ID: I20180122001809 |
| Provider Name | Natalie M Sheehan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508374109 PECOS PAC ID: 0042572976 Enrollment ID: I20180313000753 |
| Provider Name | Katherine J Kavanaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821058306 PECOS PAC ID: 6103850235 Enrollment ID: I20180315001495 |
| Provider Name | Leah J. Blake |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558757724 PECOS PAC ID: 0749544252 Enrollment ID: I20180509002784 |
| Provider Name | Lin Hao |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1528325529 PECOS PAC ID: 3173839446 Enrollment ID: I20180516002439 |
| Provider Name | Diane H Zug |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578596227 PECOS PAC ID: 1557365558 Enrollment ID: I20180710002281 |
| Provider Name | Aubrey Pitts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124500947 PECOS PAC ID: 5496093585 Enrollment ID: I20190215000152 |
| Provider Name | Michael Miller |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1588762710 PECOS PAC ID: 4082615463 Enrollment ID: I20190321000378 |
| Provider Name | Jose Luis Lopez Rivera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164710182 PECOS PAC ID: 4385807619 Enrollment ID: I20190327000864 |
| Provider Name | Jessica Lynn Fritz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073070199 PECOS PAC ID: 8022350198 Enrollment ID: I20190422001908 |
| Provider Name | Colton Reisinger Redding |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366889818 PECOS PAC ID: 3678876463 Enrollment ID: I20190806000712 |
| Provider Name | Hiwot Gebeye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356992192 PECOS PAC ID: 5890121412 Enrollment ID: I20200130000715 |
| Provider Name | Valerie Eckhard |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1649206244 PECOS PAC ID: 3577513928 Enrollment ID: I20200409002607 |
| Provider Name | Leona Shum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679941132 PECOS PAC ID: 0446517486 Enrollment ID: I20200414000444 |
| Provider Name | Gary V Walker |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1154667467 PECOS PAC ID: 5294040713 Enrollment ID: I20200803001235 |
| Provider Name | Kelsey Shay |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306001797 PECOS PAC ID: 9830333210 Enrollment ID: I20200803002000 |
| Provider Name | Jennifer Van Horn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023386919 PECOS PAC ID: 1355508094 Enrollment ID: I20200805000137 |
| Provider Name | Michelle E Brassil |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1518377613 PECOS PAC ID: 7618272493 Enrollment ID: I20200814002158 |
| Provider Name | Costa Pete Alimonos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235670712 PECOS PAC ID: 6507136223 Enrollment ID: I20200818002313 |
| Provider Name | Cara L Johnson |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1508095332 PECOS PAC ID: 8921245168 Enrollment ID: I20201022003888 |
| Provider Name | Becky Lynn Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588271340 PECOS PAC ID: 9335559590 Enrollment ID: I20201029002300 |
| Provider Name | Colten M Bray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710585500 PECOS PAC ID: 3870903461 Enrollment ID: I20201111000064 |
| Provider Name | Ashley Imburgia |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295201291 PECOS PAC ID: 0244576957 Enrollment ID: I20201208001108 |
| Provider Name | Laura Luehr |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922214824 PECOS PAC ID: 2860672789 Enrollment ID: I20201215003419 |
| Provider Name | Teuta N Shemshedini |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760774178 PECOS PAC ID: 9133413727 Enrollment ID: I20210316002578 |
| Provider Name | Elbert Kuo |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1770669152 PECOS PAC ID: 7315061066 Enrollment ID: I20210601001923 |
| Provider Name | John Breard |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1427219757 PECOS PAC ID: 2365612306 Enrollment ID: I20210602000299 |
| Provider Name | Travis Mason |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1578720926 PECOS PAC ID: 3678972197 Enrollment ID: I20210602002928 |
| Provider Name | Walter Wakwe |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1881910115 PECOS PAC ID: 9335389782 Enrollment ID: I20210603000393 |
| Provider Name | Brett Broussard |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1669606422 PECOS PAC ID: 6002052305 Enrollment ID: I20210603001101 |
| Provider Name | Meredith E Haskins |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1881011740 PECOS PAC ID: 8820395205 Enrollment ID: I20210615000615 |
| Provider Name | Ryan Macke |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1215034913 PECOS PAC ID: 9133388952 Enrollment ID: I20210621003456 |
| Provider Name | Francis K Hall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629495767 PECOS PAC ID: 3971725318 Enrollment ID: I20210623001031 |
| Provider Name | Diane E Reider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578145108 PECOS PAC ID: 2264833094 Enrollment ID: I20210630001101 |
| Provider Name | Dwight Slater |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1912227927 PECOS PAC ID: 0446480677 Enrollment ID: I20210726003428 |
| Provider Name | Igor Shumskiy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801214044 PECOS PAC ID: 4486873502 Enrollment ID: I20210803002200 |
| Provider Name | Rajesh Ramanathan |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1104145325 PECOS PAC ID: 3274771985 Enrollment ID: I20210811003626 |
| Provider Name | Jason Wing Tcheng |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1215137237 PECOS PAC ID: 0042522138 Enrollment ID: I20210819000338 |
| Provider Name | Joann Ikenyei |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235636333 PECOS PAC ID: 8123423530 Enrollment ID: I20210824001010 |
| Provider Name | Kevin Fulford |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063594612 PECOS PAC ID: 1355421173 Enrollment ID: I20210824001821 |
| Provider Name | Caitlin Ann Wojciehoski |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346696556 PECOS PAC ID: 1557786092 Enrollment ID: I20210825000666 |
| Provider Name | Cherie Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154960318 PECOS PAC ID: 8123424058 Enrollment ID: I20210901001172 |
| Provider Name | Adam C Stater |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295247393 PECOS PAC ID: 9931467651 Enrollment ID: I20211004003344 |
| Provider Name | Michael A Choti |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1104878099 PECOS PAC ID: 6103958020 Enrollment ID: I20211011000928 |
| Provider Name | Michel Saint-cyr |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1356432959 PECOS PAC ID: 4183614787 Enrollment ID: I20211025002285 |
| Provider Name | Paige Nicole Hiss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831851179 PECOS PAC ID: 9537558846 Enrollment ID: I20211108001010 |
| Provider Name | Elissa Test Serapio |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508209669 PECOS PAC ID: 1254623200 Enrollment ID: I20211112000125 |
| Provider Name | Supriya Jain |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1639597529 PECOS PAC ID: 9830314889 Enrollment ID: I20220106001838 |
| Provider Name | Emily Grade |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1437124922 PECOS PAC ID: 4385775493 Enrollment ID: I20220107000689 |
| Provider Name | Subashini T Furman |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1366508814 PECOS PAC ID: 0547357253 Enrollment ID: I20220111002528 |
| Provider Name | Bradley Prestidge |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1134126220 PECOS PAC ID: 5890754766 Enrollment ID: I20220126001839 |
| Provider Name | Mohamed Khan |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1841297611 PECOS PAC ID: 9436143930 Enrollment ID: I20220127003065 |
| Provider Name | William Grigg |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578050266 PECOS PAC ID: 9234476300 Enrollment ID: I20220204000744 |
| Provider Name | Bethany Nicole Hileman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639631112 PECOS PAC ID: 2567704018 Enrollment ID: I20220301000340 |
| Provider Name | Benjamin Fischer Valuck |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1023351673 PECOS PAC ID: 3870736028 Enrollment ID: I20220513000198 |
| Provider Name | Gregory Wilkerson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699171538 PECOS PAC ID: 9638448053 Enrollment ID: I20220618000311 |
| Provider Name | Randall James Brenneman |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1366899841 PECOS PAC ID: 2365737939 Enrollment ID: I20220718003498 |
| Provider Name | Aatif Mansoor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033641709 PECOS PAC ID: 0547535460 Enrollment ID: I20220816001757 |
| Provider Name | Ryan Bower |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730192857 PECOS PAC ID: 9436192283 Enrollment ID: I20220914002779 |
| Provider Name | Ronny Meunier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518152289 PECOS PAC ID: 0244409951 Enrollment ID: I20221019001719 |
| Provider Name | Sameh G Abuerreish |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1447246202 PECOS PAC ID: 8527145671 Enrollment ID: I20221020000221 |
| Provider Name | Brenner Freeman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487048393 PECOS PAC ID: 7012296528 Enrollment ID: I20230107000128 |
| Provider Name | Irene Ma |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1770801870 PECOS PAC ID: 2668612243 Enrollment ID: I20230113000024 |
| Provider Name | Alan Sears |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982864856 PECOS PAC ID: 8527384304 Enrollment ID: I20230130000503 |
| Provider Name | Epameinondas Dogeas |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1639411507 PECOS PAC ID: 2668614660 Enrollment ID: I20230712004420 |
| Provider Name | Fady Fn Farag |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1114440690 PECOS PAC ID: 6709200652 Enrollment ID: I20230724000755 |
| Provider Name | Mohit Shiv Agarwal |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1609371459 PECOS PAC ID: 3577817741 Enrollment ID: I20230726001262 |
| Provider Name | Franc Wallace |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1326026915 PECOS PAC ID: 6608826177 Enrollment ID: I20230815000892 |
| Provider Name | Garrett Sanford Mayo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619590494 PECOS PAC ID: 9133582877 Enrollment ID: I20230829002933 |
| Provider Name | Wing Hei Hui |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477246593 PECOS PAC ID: 8224491535 Enrollment ID: I20230901002186 |
| Provider Name | Emily Simons |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205368263 PECOS PAC ID: 3274806716 Enrollment ID: I20230905000951 |
| Provider Name | Danielle Bergman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437340437 PECOS PAC ID: 6002984697 Enrollment ID: I20230920000454 |
| Provider Name | Kris Mehta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437560646 PECOS PAC ID: 0042512592 Enrollment ID: I20230922001940 |
| Provider Name | Snehankita Calarese |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1730349820 PECOS PAC ID: 9739476722 Enrollment ID: I20231002001700 |
| Provider Name | Jeffrey Richmond |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1184699688 PECOS PAC ID: 1850463308 Enrollment ID: I20231024002656 |
| Provider Name | Adam Larkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841635406 PECOS PAC ID: 0143453936 Enrollment ID: I20231030002125 |
| Provider Name | Christina Gamboa |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1144563370 PECOS PAC ID: 3971893322 Enrollment ID: I20231211000632 |
| Provider Name | Mark Dziemianowicz |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1154776029 PECOS PAC ID: 3779852454 Enrollment ID: I20240405002096 |
| Provider Name | Zeeshan Tariq |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1194958967 PECOS PAC ID: 1557585304 Enrollment ID: I20240406000091 |
Banner Health Physicians Colorado Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2001 70th Ave, Greeley, CO 80634 Phone: 970-392-2135 Fax: 970-378-3825 | |
Banner Health Physicians Colorado Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 710 11th Ave Ste 106, Greeley, CO 80631 Phone: 970-352-6353 | |
Banner Health Physicians Colorado Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2001 70th Ave Ste 300, Greeley, CO 80634 Phone: 970-810-6353 | |
Ncmc Specialty Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1801 16th St, Greeley, CO 80631 Phone: 970-378-4475 | |
Ncmc Specialty Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1800 15th St, Suite 320, Greeley, CO 80631 Phone: 970-350-6953 | |
Bond Children's Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 E 26th St, Greeley, CO 80631 Phone: 970-702-2675 Fax: 970-350-4645 | |
Immersiv Health Of Colorado, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1715 61st Ave Ste 103, Greeley, CO 80634 Phone: 512-869-9323 |