CORWIN CLINIC SURGICAL PROFESSIONAL CORP (NPI# 1356492219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356492219 |
| Entity Type | Organization |
| Organization Name | CORWIN CLINIC SURGICAL PROFESSIONAL CORP |
| Other Organization Name | CORWIN CLINIC SURGICAL, PC |
| Practice Address |
1925 E Orman Ave Ste A109 Pueblo CO 81004-3555 |
| Practice Telephone | 7195640210 |
| Practice Fax Number | 7195649483 |
| Mailing Telephone | 7195640210 |
| Mailing Fax Number | 7195649483 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2011-03-23 |
| Authorized Official Name | GARY E. LANE (PRESIDENT) |
| Authorized Official Telephone | 7195640210 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 04011417 | 05 |
| Other Name | Type Code |
|---|---|
| Corwin Clinic Surgical, PC | Other Name - Individual/Organization |
| Street Address |
1925 E ORMAN AVE STE A109 |
| City | PUEBLO |
| State | CO |
| Zip Code | 81004-3555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851788632 | Corwin Clinic Family Medicine Pllc | Family Medicine | 1925 E Orman Ave Ste A109, Pueblo, CO 81004-3555 | 2015-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780155929 | Renee C Lane | Nurse Practitioner | 1925 E. Orman Ave. Ste. A109, Pueblo, CO 81004 | 2018-12-16 |
| 1215406913 | Kaiser Foundation Healthplan of Colorado | Pharmacy | 2625 W. Pueblo Blvd, Pueblo, CO 81004 | 2018-11-26 |
| 1053895532 | Rebecka Ann Reatherford | Nurse Practitioner | St Mary-corwin Medical Center, 1008 Minnequa Ave, Pueblo, CO 81004 | 2018-09-20 |
| 1124510821 | Angela M Sillas-green | Counselor | 327 Colorado Ave., Pueblo, CO 81004 | 2018-05-30 |
| 1558898569 | Alexandra R B King | Family Medicine | Southern Colorado Family Medicine, 902 Lakeview Avenue, Pueblo, CO 81004 | 2017-05-22 |
| 1578098752 | James Williams | Counselor | 414 Broadway Ave, Pueblo, CO 81004 | 2017-04-26 |
| 1740732601 | Valerie A Senger | Counselor | 635 W Corona Ave Ste 214, Pueblo, CO 81004 | 2016-10-26 |
| 1194111500 | A New Leaf Therapy, Pllc | Community/Behavioral Health | 327 Colorado Ave, Pueblo, CO 81004 | 2015-04-13 |
| 1619371671 | Mariah Mcginnis | Registered Nurse | 1232 Van Buren St., Pueblo, CO 81004 | 2014-10-20 |
| 1730593112 | Maritza Martinez | Registered Nurse | 1026 Wabriendo Ave, Pueblo, CO 81004 | 2014-06-13 |
| Find all providers in zip 81004 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790335909 | Parkview Ancillary Services | Specialist | 4100 Jerry Murphy, Pueblo, CO 81001-1046 | 2019-09-19 |
| 1225595630 | Kimberly Warfield | Specialist | 5825 W Hwy 78, Pueblo, CA 81005 | 2019-02-22 |
| 1245636810 | Meredith Peterson | Specialist | 3902 Sandalwood Ln, Suite 140, Pueblo, CO 81005-7501 | 2014-11-10 |
| 1073836029 | Karl Hapcic, Md, LLC | Specialist | 1315 S Pueblo Blvd Ste 110, Pueblo, CO 81005-2192 | 2010-03-04 |
| 1831309129 | J. Valentine Cichon, Md PC | Specialist | 312 N Prairie Ave, Pueblo, CO 81005-1371 | 2007-05-23 |
| 1124237730 | Larry Edward Terrell | Specialist | 1711 E Evans Ave, Pueblo, CO 81004-3349 | 2007-05-21 |
| 1851412134 | Southern Colorado Ent & Allergy LLC | Specialist | 3676 Parker Blvd Ste 320, Pueblo, CO 81008-2213 | 2007-04-03 |
| 1841391596 | William V Watson | Specialist | 3530 Spaulding Ave, Pueblo, CO 81008-2209 | 2006-09-26 |
| 1265477046 | Camille George Azar | Specialist | 1020 Lakeview Ave, Pueblo, CO 81004-3508 | 2006-06-17 |
| 1386699486 | Southern Colorado Radiologists, P.C. | Specialist | 1619 N Greenwood St Ste 103, Pueblo, CO 81003-2655 | 2006-05-24 |
| 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.