BOULDER GYNECOLOGY & MINIMALLY INVASIVE SURGERY (NPI# 1194071605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194071605 |
| Entity Type | Organization |
| Organization Name | BOULDER GYNECOLOGY & MINIMALLY INVASIVE SURGERY |
| Other Organization Name | BOULDER GYNECOLOGY |
| Practice Address |
4800 Riverbend Rd Suite 200 Boulder CO 80301-2636 |
| Practice Telephone | 7203822621 |
| Practice Fax Number | 7203822625 |
| Mailing Telephone | 7203822621 |
| Mailing Fax Number | 7203822625 |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2012-08-02 |
| Authorized Official Name | LISA LEPINE (PRESIDENT/OWNER) |
| Authorized Official Telephone | 7203822621 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
43874 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 48574279 | 05 | |
| CO | MEDICARE ID - TYPE UNSPECIFIED | 802492 | 01 |
| Other Name | Type Code |
|---|---|
| Boulder Gynecology | Other Name - Individual/Organization |
| Street Address |
4800 RIVERBEND RD SUITE 200 |
| City | BOULDER |
| State | CO |
| Zip Code | 80301-2636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770572653 | Todd David Turner | Internal Medicine | 4800 Riverbend Rd, Suite 200, Boulder, CO 80301-2636 | 2005-10-13 |
| 1497185888 | Erin Crawley | Advanced Practice Midwife | 4800 Riverbend Rd, Boulder, CO 80301-2636 | 2013-11-20 |
| 1144504168 | Kala Kluender | Registered Nurse | 4800 Riverbend Rd, Suite 150, Boulder, CO 80301-2636 | 2011-10-10 |
| 1124291315 | Ellen Wall Tucker | Social Worker | 4800 Riverbend Rd, Suite 200, Boulder, CO 80301-2636 | 2008-04-08 |
| 1609899251 | Amie Lynn Meditz | Internal Medicine | 4800 Riverbend Rd, Suite 200, Boulder, CO 80301-2636 | 2006-07-25 |
| 1710960380 | Alicia E Maltzman | Nurse Practitioner | 4800 Riverbend Rd, Suite 200, Boulder, CO 80301-2636 | 2005-11-28 |
| 1295717049 | Heather C Pujet | Internal Medicine | 4800 Riverbend Rd, Suite 200, Boulder, CO 80301-2636 | 2005-11-17 |
| 1902888746 | Mark D King | Internal Medicine | 4800 Riverbend Rd, Suite 200, Boulder, CO 80301-2636 | 2005-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265031454 | Jonathan William Garson | Social Worker | 1790 30th St., Boulder, CO 80301 | 2020-10-20 |
| 1164048161 | Crossroads Medical Center | Family Medicine | 2760 29th St., Suite 28, Boulder, CO 80301 | 2020-06-25 |
| 1316585045 | Karissa Marlene Smith | Registered Nurse | 4770 Pearl Street, Suite A, Boulder, CO 80301 | 2019-12-12 |
| 1184273864 | National Doula Network | Doula | 5918 Gunbarrel Ave Apt E, Boulder, CO 80301 | 2019-09-05 |
| 1861047086 | Samuel Shay | Chiropractor | 1750 30th St, Ste 1, #226, Boulder, CO 80301 | 2019-08-05 |
| 1124504808 | Be Free Live Now LLC | Social Worker | 2945 Center Creen Court, Suite G211, Boulder, CO 80301 | 2018-07-16 |
| 1720596703 | Janis Dochterman | Counselor | 5378 Sterling Drive, Studio #3, Boulder, CO 80301 | 2018-01-12 |
| 1033628631 | Whitney Shea | Physical Therapy Assistant | 3020 Carbon Place, #330, Physical Therapy of Boulder, Boulder, CO 80301 | 2017-09-26 |
| 1538688908 | Kyle N. Daniel Dds PC | Dentist | 2830 Valmont Rd, Boulder, CO 80301 | 2017-09-16 |
| 1497205231 | Jenna Orosco | Counselor | 2945 Center Green Ct. Suite H, Suite H, Boulder, CO 80301 | 2016-10-05 |
| Find all providers in zip 80301 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184838732 | David O Thayer | Obstetrics & Gynecology | 1155 Alpine Ave Ste 230, Boulder, CO 80304-3407 | 2007-05-10 |
| 1912085952 | Ann Louise Mattson | Obstetrics & Gynecology | 119 Ucb, Boulder, CO 80309-0119 | 2006-11-01 |
| 1205942422 | Mary A Macsalka | Obstetrics & Gynecology | 4745 Arapahoe Ave Ste 110, Boulder, CO 80303-1082 | 2006-08-21 |
| 1639305873 | Ruth Kibbee Weinberg | Obstetrics & Gynecology | 2855 Valmont Rd, Boulder, CO 80301-1309 | 2009-06-02 |
| 1497925986 | Cchmd Corp | Obstetrics & Gynecology | 4745 Arapahoe Ave Ste 110, Boulder, CO 80303-1082 | 2008-03-11 |
| 1447362553 | Christine C Hansen | Obstetrics & Gynecology | 4745 Arapahoe Ave Ste 110, Boulder, CO 80303-1082 | 2006-08-31 |
| 1073629291 | Robert E Macsalka | Obstetrics & Gynecology | 4745 Arapahoe Ave Ste 110, Boulder, CO 80303-1082 | 2006-08-21 |
| 1730295940 | Catherine A. Ryan | Obstetrics & Gynecology | 4745 Arapahoe Ave Ste 110, Boulder, CO 80303-1082 | 2006-08-21 |
| 1801870530 | John R Imig | Obstetrics & Gynecology | 4745 Arapahoe Ave, Suite 200, Boulder, CO 80303-1080 | 2005-12-06 |
| 1922082593 | Sherburne Macfarlan | Obstetrics & Gynecology | 4745 Arapahoe Ave, Suite 200, Boulder, CO 80303-1080 | 2005-12-06 |
| Find all providers in BOULDER | ||||
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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.