KATRINA MARIE PACK (NPI# 1144517947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144517947 |
| Entity Type | Individual |
| Full Name | KATRINA MARIE PACK |
| Other Name | KATRINA MARIE PACK |
| Practice Address |
300 Exempla Cir Suite 230 Lafayette CO 80026-3397 |
| Mailing Address |
Po Box 17528 Denver CO 80217-0528 |
| Practice Telephone | 3036896591 |
| Practice Fax Number | 3033067753 |
| Mailing Telephone | 3033067101 |
| Mailing Fax Number | 3033067753 |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2018-09-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
DR.0056896 | CO | Allopathic & Osteopathic Physicians |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
MT200363 | PA | Allopathic & Osteopathic Physicians |
| Y | 2084N0008X |
Psychiatry & Neurology Specialization: Neuromuscular Medicine |
DR.0056896 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | COLORADO MEDICAL LICENSE | DR.0056896 | 01 |
| Street Address |
300 EXEMPLA CIR SUITE 230 |
| City | LAFAYETTE |
| State | CO |
| Zip Code | 80026-3397 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063485936 | Ernest Edward Nitka | Psychiatry & Neurology | 300 Exempla Cir, Suite 230, Lafayette, CO 80026-3397 | 2006-02-09 |
| 1598379984 | Scl Health Medical Group - Denver, LLC | Internal Medicine | 300 Exempla Cir, Lafayette, CO 80026-3397 | 2020-09-02 |
| 1821538174 | Lauren Elizabeth Hammer | Nurse Practitioner | 300 Exempla Cir, Suite 470, Lafayette, CO 80026-3397 | 2017-03-06 |
| 1952858185 | Heather Dunham | Nurse Practitioner | 300 Exempla Cir, Suite 420, Lafayette, CO 80026-3397 | 2016-09-06 |
| 1972927382 | Froc, PC | Orthopaedic Surgery | 300 Exempla Cir, Suite 200, Lafayette, CO 80026 | 2014-02-06 |
| 1518300367 | Sarah Braden White | Emergency Medicine | 300 Exempla Cir, #204, Lafayette, CO 80026-3397 | 2013-04-11 |
| 1700184322 | Lafayette Pediatrics and Internal Medicine | Clinic/Center | 300 Exempla Cir, Suite 420, Lafayette, CO 80026-3397 | 2011-03-06 |
| 1003120502 | Erik Berger | Internal Medicine | 300 Exempla Cir, Suite 300, Lafayette, CO 80026-3397 | 2010-07-27 |
| 1154654804 | Banner Greeley Specialists | Clinic/Center | 300 Exempla Cir, Suite 200, Lafayette, CO 80026-3397 | 2009-09-14 |
| 1467608752 | Ncmc Specialty Clinic | Clinic/Center | 300 Exempla Cir, Suite 200, Lafayette, CO 80026-3397 | 2008-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528671690 | Julia Michele Colton | Occupational Therapist | 110 S. Roosevelt Ave, Lafayette, CO 80026 | 2020-08-28 |
| 1265045900 | Amber M. Roter | Social Worker | 588 N Us-287 Co, Suite 200, Lafayette, CO 80026 | 2020-08-24 |
| 1669008314 | Dr. Sunda Friedman Tebockhorst Psychologicl Services, Ltd | Clinic/Center | 588 N Hwy 287, Suite 200, Lafayette, CO 80026 | 2020-03-13 |
| 1659918910 | Emily Nicole Pearson | Behavior Technician | 961 Sandstone Circle, Lafayette, CO 80026 | 2019-12-05 |
| 1790320612 | Gs Campus Asc, LLC | Clinic/Center | Lafayette Surgery Center, 340 Exempla Circle, Suite #400, Lafayette, CO 80026 | 2019-11-14 |
| 1639711864 | Martina Christina Holzach | Student in an Organized Health Care Education/Training Program | 1455 Dixon Ave, Suite #300, Lafayette, CO 80026 | 2019-10-09 |
| 1104474055 | 2nd Star Counseling | Clinic/Center | 260 S. Public Rd, Lafayette, CO 80026 | 2019-09-03 |
| 1912460015 | Premier Eye Surgery Center of Colorado, LLC | Clinic/Center | 1050 W. South Boulder Road, Lafayette, CO 80026 | 2019-04-08 |
| 1144704883 | Nikole J Randolph | Nutritionist | 2770 Dagny Way Suite 210, Lafayette, CO 80026 | 2018-09-19 |
| 1609388842 | Claro Scientific Laboratories Corp | Clinical Medical Laboratory | 1408 Horizon Ave Ste 101, Lafayette, CO 80026 | 2017-10-27 |
| Find all providers in zip 80026 | ||||
| Taxonomy Code | 2084N0008X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neuromuscular Medicine |
| A neurologist or child neurologist who specializes in the diagnosis and management of disorders of nerve, muscle or neuromuscular junction, including amyotrophic lateral sclerosis, peripheral neuropathies (e.g., diabetic and immune mediated neuropathies), various muscular dystrophies, congenital and acquired myopathies, inflammatory myopathies (e.g., polymyositis, inclusion body myositis) and neuromuscular transmission disorders (e.g., myasthenia gravis, Lambert-Eaton myasthenic syndrome). |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: new] Additional Resources: American Board of Psychiatry and Neurology, 2007. http://www.abpn.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Psychiatry and Neurology |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952667818 | Laura Ann Foster | Psychiatry & Neurology | 12605 E 16th Ave, Aurora, CO 80045 | 2012-04-04 |
| 1225360902 | Frontier Neurology and Neuromuscular Clinic Pllc | Psychiatry & Neurology | 5730 Ward Rd, Suite 206, Arvada, CO 80002-1300 | 2010-02-05 |
| 1457493660 | Boulder Valley Neurlogy Inc | Psychiatry & Neurology | 1044 S 88th St, Suite 102, Louisville, CO 80027-9417 | 2007-02-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.