DR. JERED NYSTROM (NPI# 1366903726) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366903726 |
Entity Type | Individual |
Full Name | DR. JERED NYSTROM |
Credential | MD |
Practice Address |
12401 E 17th Ave Aurora CO 80045-2548 |
Mailing Address |
5000 W Chambers St Milwaukee WI 53210-1650 |
Practice Telephone | 7208480000 |
Mailing Telephone | 4144472195 |
Enumeration Date | 2019-03-28 |
Last Update Date | 2020-05-15 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
Address | Telephone Number | Fax Number |
---|---|---|
5000 W Chambers St, Milwaukee, WI 532101650 | 4144472195 |
Street Address |
12401 E 17TH AVE |
City | AURORA |
State | CO |
Zip Code | 80045-2548 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083648679 | Jeannette Guerrasio | Internal Medicine | 12401 E 17th Ave, Mail Code F782, Aurora, CO 80045-2548 | 2006-07-10 |
1366049116 | Laurie Lahr | Nurse Practitioner | 12401 E 17th Ave, Aurora, CO 80045-2548 | 2020-10-05 |
1407479736 | John White | Student in an Organized Health Care Education/Training Program | 12401 E 17th Ave, Aurora, CO 80045-2548 | 2020-05-20 |
1619517414 | Bethany Louise Zablotsky | Physician Assistant | 12401 E 17th Ave, Aurora, CO 80045-2548 | 2020-01-09 |
1316585425 | Elizabeth Mcwilliams | Physician Assistant | 12401 E 17th Ave, Aurora, CO 80045-2548 | 2019-12-19 |
1831731819 | Matthew David Ferraro | Physician Assistant | 12401 E 17th Ave, Aurora, CO 80045-2548 | 2019-10-11 |
1144880725 | Kari Waterman | Pediatrics | 12401 E 17th Ave, Aurora, CO 80045-2548 | 2019-06-17 |
1801357314 | Nicholas Maxwell Pflederer | Student in an Organized Health Care Education/Training Program | 12401 E 17th Ave, Aurora, CO 80045-2548 | 2019-03-27 |
1538632484 | Jordi Garcia-timko | Anesthesiologist Assistant | 12401 E 17th Ave, Aurora, CO 80045-2548 | 2019-01-03 |
1124595160 | Danielle Wade | Social Worker | 12401 E 17th Ave, Aurora, CO 80045-2548 | 2018-10-29 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942817408 | Salwa Mourtada Bamba | Nurse Practitioner | University of Colorado Medicine, 12631 East 17th Avenue, Aurora, CO 80045 | 2020-09-29 |
1114545233 | Chun Cheong Tsui | Student in an Organized Health Care Education/Training Program | 12801 E. 17th Avenue, Ms 8117, Aurora, CO 80045 | 2020-07-07 |
1487278719 | James Charles Tuka IIi | Social Worker | 1700 North Wheeling, Aurora, CO 80045 | 2020-06-02 |
1427677806 | Justin Yu | Student in an Organized Health Care Education/Training Program | 12631 E. 17th Ave. Ms B205, Aurora, CO 80045 | 2020-04-15 |
1558980011 | Erik Von Polsdofer | Student in an Organized Health Care Education/Training Program | Academic Office 1; Department of Pathology, 12631 East 17th Avenue, Aurora, CO 80045 | 2020-04-14 |
1831718568 | Luke Porter Bacon | Student in an Organized Health Care Education/Training Program | 3001 East 17th Place, Aurora, CO 80045 | 2020-04-13 |
1366061368 | Hilary Novatt | Student in an Organized Health Care Education/Training Program | 12631 E 17th Ave, B198-6, Room 4007, Aurora, CO 80045 | 2020-04-10 |
1376195362 | Katie Tuck | Pharmacist | 1700 North Wheeling Street (119), Fs-111o, Aurora, CO 80045 | 2019-07-10 |
1518529130 | Ronak Kamal Kapadia | Student in an Organized Health Care Education/Training Program | 12700 E. 19th Ave, Ms B182 Rm 5104, Aurora, CO 80045 | 2019-07-03 |
1245898253 | Rasha Elbadry Ahmed | Student in an Organized Health Care Education/Training Program | Childrens Hospital Colorado Pediatric Neurosurgery, 13123e. 16th Ave, B330, Aurora, CO 80045 | 2019-06-04 |
Find all providers in zip 80045 |
Taxonomy Code | 390200000X |
Grouping | Student, Health Care |
Classification | Student in an Organized Health Care Education/Training Program |
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
Notes: [1/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043827827 | Jessica Paulette Flowers | Student in an Organized Health Care Education/Training Program | 23608 E Fremont Cir Unit 304, Aurora, CO 80016-2615 | 2020-09-25 |
1346859543 | Amandeep K Pentlia | Student in an Organized Health Care Education/Training Program | 13021 E 21st Ave, Aurora, CO 80045-7454 | 2020-07-24 |
1114545233 | Chun Cheong Tsui | Student in an Organized Health Care Education/Training Program | 12801 E. 17th Avenue, Ms 8117, Aurora, CO 80045 | 2020-07-07 |
1902424062 | Janell Herrera | Student in an Organized Health Care Education/Training Program | 856 Columbia St, Aurora, IL 60505-2816 | 2020-07-06 |
1457978611 | David Immanuel Freeman Fountain | Student in an Organized Health Care Education/Training Program | 3697 S Cathay Cir, Aurora, CO 80013-3619 | 2020-07-02 |
1568087492 | Jimmy D Joseph | Student in an Organized Health Care Education/Training Program | 1290 Chambers Rd # 80011, Aurora, CO 80011-7117 | 2020-06-16 |
1013532811 | Jay Patrick Lewis | Student in an Organized Health Care Education/Training Program | 7009 S Netherland Way, Aurora, CO 80016-2347 | 2020-06-08 |
1649893546 | Megan Heman | Student in an Organized Health Care Education/Training Program | 23068 Lawrence 1200, Aurora, MO 65605-8252 | 2020-05-26 |
1689296915 | Rafael Martinez Perez | Student in an Organized Health Care Education/Training Program | 12631 E 17th Ave # 5001, Aurora, CO 80045-2527 | 2020-05-08 |
1790305704 | Evan Tkaczyk | Student in an Organized Health Care Education/Training Program | 3461 Saint Barthelemy Ln, Aurora, IL 60504-3120 | 2020-04-20 |
Find all providers in AURORA |
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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.