DR. C. GLEN FERGUSON (NPI# 1245330141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245330141 |
| Entity Type | Individual |
| Full Name | DR. C. GLEN FERGUSON |
| Credential | D.O. |
| Practice Address |
1615 Bonforte Blvd Pueblo CO 81001-1602 |
| Practice Telephone | 7192965840 |
| Practice Fax Number | 7195420746 |
| Mailing Telephone | 7192965840 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2008-01-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | 17205 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 01172055 | 05 | |
| CO | COLORADO STATE LICENSE | 17205 | 01 |
| BCBS | FE03792 | 01 | |
| CO | DEA | AF6168012 | 01 |
| CO | 94559040 | 05 |
| Street Address |
1615 BONFORTE BLVD |
| City | PUEBLO |
| State | CO |
| Zip Code | 81001-1602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770190373 | Felicia Elizabeth Cover | Counselor | 1615 Bonforte Blvd, Pueblo, CO 81001-1602 | 2020-09-28 |
| 1962969790 | Richard Phillip Armijo | Counselor | 1615 Bonforte Blvd, Pueblo, CO 81001-1602 | 2019-02-28 |
| 1427560986 | Ann Michele Newman | Social Worker | 1615 Bonforte Blvd, Pueblo, CO 81001-1602 | 2017-10-24 |
| 1407381643 | Carla Throndson | Counselor | 1615 Bonforte Blvd, Pueblo, CO 81001-1602 | 2017-04-25 |
| 1790223634 | Connie Palm | Counselor | 1615 Bonforte Blvd, Pueblo, CO 81001-1602 | 2017-02-10 |
| 1710105333 | C. Glen Ferguson D.o. P.C. | Anesthesiology | 1615 Bonforte Blvd, Pueblo, CO 81001-1602 | 2007-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588222863 | 1111 Bonforte Opco LLC | Respite Care | 855 Hunter Dr., Pueblo, CO 81001 | 2019-06-03 |
| 1992276026 | Andrew Benjamin Basham | Counselor | 1003 Rupple St Pueblo Co 81001, 606, Pueblo, CO 81001 | 2018-12-16 |
| 1316456981 | Amy R Leibli | Nurse Practitioner | 1080 Chinook Lane, Pueblo, CO 81001 | 2017-09-26 |
| 1457781262 | Ron Concialdi | Dentist | 2037 Jerry Murphy Rd., Pueblo, CO 81001 | 2013-11-14 |
| 1609146950 | Natasha Liette Mondragon | Registered Nurse | 1302 E. 5th, Pueblo, CO 81001 | 2012-01-04 |
| 1023303575 | Malinda Lee Davis | Registered Nurse | 1302 E 5th, Pueblo, CO 81001 | 2011-06-13 |
| 1679876429 | Michael Edward Leyba | Substance Abuse Rehabilitation Facility | 4 Montebello Rd., Pueblo, CO 81001 | 2010-12-17 |
| 1609008796 | Laura Ann Mcmahon | Nurse Practitioner | 4020 Jerry Murphy Rd/, Pueblo, CO 81001 | 2009-08-21 |
| 1730380882 | Corrine Stella Tafoya | Counselor | 44 Calhoun Rd, Pueblo, CO 81001 | 2007-05-29 |
| 1518171008 | George Henry Beck | Dentist | 1700 N Salem Ave, Suite A, Pueblo, CO 81001 | 2007-05-10 |
| Find all providers in zip 81001 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588856116 | Lars Vanetten | Anesthesiology | 334 Grace Ave, Pueblo, CO 81004-1032 | 2007-08-17 |
| 1023221041 | Christopher W. Harper | Anesthesiology | 400 W. 16th St., Pueblo, CO 81003-2745 | 2007-05-07 |
| 1245290790 | David Potter | Anesthesiology | 41 Montebello Rd Ste 116, Pueblo, CO 81001-1366 | 2006-03-27 |
| 1053370429 | Eric A Bernauer | Anesthesiology | 916 Indiana Ave Ste 120, Pueblo, CO 81004-3572 | 2006-03-22 |
| 1528063187 | James W Mccanless | Anesthesiology | 650 Dittmer Ave, Pueblo, CO 81005 | 2005-06-20 |
| 1366447922 | Gregory S Larsen | Anesthesiology | 1008 Minnequa Ave, Pueblo, CO 81004-3733 | 2005-06-20 |
| 1992700694 | James E Caldwell | Anesthesiology | 400 W 16th St, Pueblo, CO 81003-2745 | 2005-06-17 |
| 1114560760 | Parkview Ancillary Services | Anesthesiology | 408 North Main Street, Floor 2, Pueblo, CO 81003-3124 | 2019-10-25 |
| 1457863235 | James W. Garland D.o. LLC | Anesthesiology | 650 Dittmer Ave, Pueblo, CO 81005-1212 | 2017-11-01 |
| 1679992507 | Tessa Emerald Newman | Anesthesiology | 400 W 16th St, Pueblo, CO 81003 | 2014-04-08 |
| Find all providers in PUEBLO | ||||
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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.