DR. MICHELLE MARIE KLISMITH (NPI# 1437231990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437231990 |
| Entity Type | Individual |
| Full Name | DR. MICHELLE MARIE KLISMITH |
| Credential | M.D. |
| Practice Address |
550 W Highway 105 Monument CO 80132-9122 |
| Mailing Address |
5575 Tech Center Dr Ste 106 Colorado Springs CO 80919-2353 |
| Practice Telephone | 7194889860 |
| Practice Fax Number | 7194889868 |
| Mailing Telephone | 7195901177 |
| Mailing Fax Number | 7195901360 |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2019-12-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 53709 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200111620A | 05 | |
| CO | 81177836 | 05 |
| Street Address |
550 W HIGHWAY 105 |
| City | MONUMENT |
| State | CO |
| Zip Code | 80132-9122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851372486 | Wendy C Jones | Physical Therapist | 550 W Highway 105, Monument, CO 80132-9122 | 2005-11-10 |
| 1215568597 | Optumcare Colorado Springs, LLC | Family Medicine | 550 W Highway 105, Monument, CO 80132-9122 | 2020-01-27 |
| 1619369402 | Katherine Michelle Stensland | Physician Assistant | 550 W Highway 105, Monument, CO 80132-9122 | 2015-03-03 |
| 1528286192 | Gayleen Rachele Prausa | Physician Assistant | 550 W Highway 105, Monument, CO 80132-9122 | 2007-04-20 |
| 1457452567 | Kori L Schulte | Nurse Practitioner | 550 W Highway 105, Monument, CO 80132-9122 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407314131 | 100 Percent Chiropractic Rodgers LLC | Chiropractor | 1495 Cipriani Loop, Monument, CO 80132 | 2019-03-12 |
| 1417421025 | Jackson Creek Assisted Living, LLC | Assisted Living Facility | 16601 Jackson Creek Parkway, Monument, CO 80132 | 2019-01-16 |
| 1609357144 | Baptist Road Dental | Dentist | 1036 Baptist Road, Monument, CO 80132 | 2018-08-23 |
| 1609352186 | Mountain Springs Recovery LLC | Substance Abuse Rehabilitation Facility | 1865 Woodmoor Dr, Monument, CO 80132 | 2018-07-17 |
| 1528553070 | Comfort Dental Oral Surgery Colorado Springs LLC | Dentist | 556 W. Hwy 105, Monument, CO 80132 | 2018-06-27 |
| 1265926844 | Lauren Elizabeth Nasuti | Massage Therapist | 17232 Jackson Creek Pkwy, #300, Monument, CO 80132 | 2018-06-18 |
| 1578079224 | Courtney Hopkins | Behavior Technician | 590 Hwy 105 Suite 105, Monument, CO 80132 | 2017-12-18 |
| 1033623475 | Deborah Tebault | Counselor | 220 N. Washington St., Suite F, Monument, CO 80132 | 2017-11-21 |
| 1902347578 | Monument Dentists and Orthodontics, LLP | Dentist | 950 W Baptist Road, Suite 100, Monument, CO 80132 | 2017-03-16 |
| 1972909463 | Timothy P O'connor | Counselor | 3065 Mt. Herman Rd., Monument, CO 80132 | 2014-11-10 |
| Find all providers in zip 80132 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033722376 | Poudre Valley Medical Group, LLC | Family Medicine | 15854 Jackson Creek Pkwy Unit 120, Monument, CO 80132-8663 | 2020-08-26 |
| 1790320844 | Kalene Mears Ethington | Family Medicine | 188 Walters Creek Dr, Monument, CO 80132-7941 | 2019-11-13 |
| 1336544006 | Michael Torres | Family Medicine | 2595 Bricker Rd, Monument, CO 80132-9621 | 2014-10-23 |
| 1093052045 | Orville Glenn Neufeld | Family Medicine | 18335 Sloan Ln, Pob 2610, Monument, CO 80132-8814 | 2013-01-10 |
| 1487981908 | Leo Martin Hattrup | Family Medicine | 750 Lancers Ct W, Monument, CO 80132-2806 | 2009-11-04 |
| 1134355977 | Stephanie Michelle Mccrery | Family Medicine | 17230 Jackson Creek Pkwy Ste 300, Monument, CO 80132-7306 | 2009-06-08 |
| 1710192737 | Walter Lee Larimore | Family Medicine | 54 S Sherwood Gln, Monument, CO 80132-8750 | 2007-05-12 |
| 1235140658 | Kristin Scott | Family Medicine | 17230 Jackson Creek Pkwy, Suite 300, Monument, CO 80132-7301 | 2006-08-10 |
| 1669422382 | Warren Jaeger | Family Medicine | 550 Highway 105, Monument, CO 80132-9125 | 2006-05-11 |
| 1558350819 | Eric A Brewner | Family Medicine | 1770 Deer Creek Rd, Monument, CO 80132-9088 | 2005-10-19 |
| Find all providers in MONUMENT | ||||
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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.