DR. TRAVIS D ARCHULETA (NPI# 1457335010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457335010 |
| Entity Type | Individual |
| Full Name | DR. TRAVIS D ARCHULETA |
| Credential | MD |
| Practice Address |
3676 Parker Blvd Suite 350 Pueblo CO 81008-2212 |
| Mailing Address |
7951 E Maplewood Ave Suite 300 Greenwood Village CO 80111-4723 |
| Practice Telephone | 7192966000 |
| Practice Fax Number | 7195451146 |
| Mailing Telephone | 3039307800 |
| Mailing Fax Number | 3039307860 |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2008-12-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
42290 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 59830875 | 05 |
| Street Address |
3676 PARKER BLVD SUITE 350 |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008-2212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922001700 | Stephen D Bast | Physician Assistant | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2005-05-24 |
| 1255945960 | Jessica Marie Anaya | Nurse Practitioner | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2020-09-01 |
| 1023658713 | Havilah R. Spurlock | Nurse Practitioner | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2020-01-09 |
| 1033625314 | Jennifer Livingston | Nurse Practitioner | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2017-12-21 |
| 1588176341 | Kenneth Morris | Physical Medicine & Rehabilitation | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2017-11-01 |
| 1053770370 | Parkview Medical Center, Inc | Clinic/Center | 3676 Parker Blvd, Suite 140, Pueblo, CO 81008-2212 | 2016-02-15 |
| 1124495163 | Kyle Sanders | Physical Therapist | 3676 Parker Blvd, Suite 370, Pueblo, CO 81008-2212 | 2015-08-25 |
| 1588057319 | James Richard Anderson | Physician Assistant | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2015-03-18 |
| 1942600150 | Adam Jennings | Physical Therapist | 3676 Parker Blvd, Suite 370, Pueblo, CO 81008-2212 | 2014-08-26 |
| 1023425386 | Amanda C Fadenrecht | Nurse Practitioner | 3676 Parker Blvd, Suite 260, Pueblo, CO 81008-2212 | 2014-07-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164058913 | Healthone Clinic Services - Oncology Hematology LLC | Internal Medicine | 3678 Parker Blvd, Pueblo, CO 81008 | 2020-03-12 |
| 1073026423 | Carmel Community Living Corporation | Respite Care | 2003 Northmoor Terrace, Suite 100, Pueblo, CO 81008 | 2017-11-08 |
| 1568987121 | Hannah Vivian Roadruck | Pharmacist | 4200 Dillon Dr., Pueblo, CO 81008 | 2017-08-04 |
| 1184170425 | Brett Burana | Dentist | 729 Us-50, Pueblo, CO 81008 | 2016-08-28 |
| 1760832885 | Irby Dental Cottage | Dental Hygienist | 2099 West St # 50, Suite 180, Pueblo, CO 81008 | 2016-06-20 |
| 1649624362 | Curley Peak Dentistry Pllc | Dentist | 1640 W Fortino Blvd, Pueblo, CO 81008 | 2016-04-19 |
| 1336507847 | Kyle Tipton | Nurse Anesthetist, Certified Registered | 4741 Eagleridge Circle, 206, Pueblo, CO 81008 | 2016-01-29 |
| 1407211931 | Center At Park West, LLC | Skilled Nursing Facility | 3727 Parker Blvd., Pueblo, CO 81008 | 2015-12-29 |
| 1417327461 | Nicole Betts | Registered Nurse | 1310 Fortino Blvd Ste D, Pueblo, CO 81008 | 2015-10-02 |
| 1437578028 | Pueblo Modern Dentistry and Orthodontics, LLP | Dentist | 727 Us Hwy 50 West, Pueblo, CO 81008 | 2014-04-10 |
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| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659306132 | High Plains Oncology,pllc | Internal Medicine | 2004 Lake Ave, Suite 110, Pueblo, CO 81004-3536 | 2006-07-12 |
| 1356502702 | High Plains Oncology Associates Pllc | Internal Medicine | 2004 Lake Ave, Suite 110, Pueblo, CO 81004-3536 | 2008-06-18 |
| 1477711901 | Sofyan Morshed Taleb Radaideh | Internal Medicine | 3676 Parker Blvd Ste 350, Pueblo, CO 81008-2213 | 2008-05-31 |
| 1811188253 | Muath Dawod | Internal Medicine | 3676 Parker Blvd Ste 350, Pueblo, CO 81008-2213 | 2007-08-08 |
| 1831173574 | Louis B Balizet | Internal Medicine | 3676 Parker Blvd, Suite 350, Pueblo, CO 81008-2212 | 2005-12-06 |
| 1215911532 | Frank L Settipani | Internal Medicine | 3676 Parker Blvd, Ste 350, Pueblo, CO 81008-2212 | 2005-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184238578 | Scl Health Medical Group - Denver, LLC | Internal Medicine | 340 Exempla Cir, Lafayette, CO 80026-3384 | 2020-09-02 |
| 1285242636 | Rocky Mountain Cancer Centers LLP | Internal Medicine | 10107 Ridgegate Pkwy Ste 300, Lone Tree, CO 80124-5642 | 2020-07-21 |
| 1356965529 | Platte Valley Medical Group, LLC | Internal Medicine | 1606 Prairie Center Pkwy Ste 270, Brighton, CO 80601-4005 | 2020-06-03 |
| 1457980617 | Poudre Valley Medical Group, LLC | Internal Medicine | 4050 Briargate Pkwy Ste C1100, Colorado Springs, CO 80920-7815 | 2020-04-08 |
| 1407351950 | University Physicians Incorporated | Internal Medicine | 13199 E Montview Blvd Ste 100, Aurora, CO 80045-7202 | 2018-03-27 |
| 1114439924 | Cancer Centers of Colorado, LLC | Internal Medicine | 1601 Lowell Blvd Ste 150, Denver, CO 80204-1545 | 2017-11-02 |
| 1760814644 | Cccric LLC | Internal Medicine | 799 E Hampden Ave Ste 500, Englewood, CO 80113-2777 | 2013-08-02 |
| 1336482769 | Tejas Patil | Internal Medicine | 12801 E 17th Ave Fl 81018, Aurora, CO 80045-2530 | 2013-04-04 |
| 1851667596 | Michelle A Levy | Internal Medicine | 1800 N Williams St Ste 200, Denver, CO 80218-1237 | 2012-03-27 |
| 1790818425 | Western Hematology Oncology Associates, P.C. | Internal Medicine | 34 Van Gordon St, Suite 160, Lakewood, CO 80228-1705 | 2007-03-13 |
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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.