KENNETH DALE SLACK (NPI# 1548375637) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548375637 |
| Entity Type | Individual |
| Full Name | KENNETH DALE SLACK |
| Credential | M.D. |
| Practice Address |
1813 Cheyenne Ave Loveland CO 80538-4244 |
| Mailing Address |
1627 E 18th St Loveland CO 80538-4209 |
| Practice Telephone | 9702036801 |
| Practice Fax Number | 9702036821 |
| Mailing Telephone | 9706630135 |
| Mailing Fax Number | 9704611422 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2011-01-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | MD2003-0686 | NM | Other Service Providers |
| Y | 207V00000X | Obstetrics & Gynecology | 44508 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 41035259 | 05 | |
| CO | 86081039 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013169879 | Kenneth Vernon Slack | Emergency Medicine | 7727 Lake Underhill Rd, Orlando, FL 32822-8224 | 2008-10-10 |
| Street Address |
1813 CHEYENNE AVE |
| City | LOVELAND |
| State | CO |
| Zip Code | 80538-4244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013974146 | Elizabeth A Howell | Obstetrics & Gynecology | 1813 Cheyenne Ave, Loveland, CO 80538-4244 | 2006-05-01 |
| 1427602077 | Breanna L Stricker | Dietitian, Registered | 1813 Cheyenne Ave, Loveland, CO 80538-4244 | 2019-07-31 |
| 1366918427 | Katharine Follin Patrick | Physician Assistant | 1813 Cheyenne Ave, Loveland, CO 80538-4244 | 2018-10-16 |
| 1164975165 | Ncmc Specialty Clinic | Clinic/Center | 1813 Cheyenne Ave, Loveland, CO 80538-4244 | 2016-07-27 |
| 1346640612 | Elizabeth Peterson | Social Worker | 1813 Cheyenne Ave, Loveland, CO 80538-4244 | 2014-08-24 |
| 1295096535 | Banner Health Physicians Colorado LLC | Clinic/Center | 1813 Cheyenne Ave, Loveland, CO 80538-4244 | 2012-06-04 |
| 1275823510 | Big Thompson Medical Group Inc. | Obstetrics & Gynecology | 1813 Cheyenne Ave, Loveland, CO 80538-4244 | 2011-04-07 |
| 1780819607 | John Michael Paddack | Urology | 1813 Cheyenne Ave, Loveland, CO 80538-4244 | 2009-05-20 |
| 1336395334 | Kurt Strom | Urology | 1813 Cheyenne Ave, Loveland, CO 80538-4244 | 2008-08-11 |
| 1730195595 | Mckee Center for Women's Health | Clinic/Center | 1813 Cheyenne Ave, Loveland, CO 80538-4244 | 2006-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295332385 | Jocelyn Stott | Social Worker | 1611 N Estrella Avenue, Loveland, CO 80538 | 2020-10-02 |
| 1184234049 | Kidstuff Child and Family Counseling, P.C. | Psychologist | 383 W. 37th St., Ste. 104, Loveland, CO 80538 | 2020-08-05 |
| 1578102752 | Shela Wagner | Student in an Organized Health Care Education/Training Program | 2603 North Monroe Ave, Loveland, CO 80538 | 2020-01-05 |
| 1184261901 | Sierra Compton | Behavior Technician | 2906 Ginnala Drive, Loveland, CO 80538 | 2019-12-01 |
| 1497306138 | Warrior Diagnostics, Inc. | Clinical Medical Laboratory | 6215 Aviation Cir., Loveland, CO 80538 | 2019-09-24 |
| 1093372625 | Kimberly Ann Boogaerts | Behavior Technician | 1437 North Denver Ave Ste 237, Loveland, CO 80538 | 2019-05-20 |
| 1033676101 | Hero Vision of Loveland, LLC | Optometrist | 3515 Mountain Lion Drive, Loveland, CO 80538 | 2019-02-26 |
| 1225509201 | Mbbk Consulting Inc. | Day Training, Developmentally Disabled Services | 4115 Georgetown Drive, Loveland, CO 80538 | 2018-12-17 |
| 1457833808 | Judy A Elliott | Speech-Language Pathologist | 3232 Williamsburg St, Loveland, CO 80538 | 2018-09-02 |
| 1245756584 | Beth Joyce Hale | Counselor | 1440 W.29th, #100, Loveland, CA 80538 | 2017-08-18 |
| Find all providers in zip 80538 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437492733 | Sarah Proehl | Obstetrics & Gynecology | 2500 Rocky Mountain Ave Ste 2150, Loveland, CO 80538-9004 | 2013-04-04 |
| 1013974146 | Elizabeth A Howell | Obstetrics & Gynecology | 1813 Cheyenne Ave, Loveland, CO 80538-4244 | 2006-05-01 |
| 1811978281 | John T Crane | Obstetrics & Gynecology | 1900 Boise Ave Ste 410, Loveland, CO 80538-5004 | 2005-11-10 |
| 1871109819 | Poudre Valley Medical Group, LLC | Obstetrics & Gynecology | 2500 Rocky Mountain Ave Ste 2100, Loveland, CO 80538-9004 | 2020-09-16 |
| 1588225015 | Fort Collins Women's Clinic, P.C. | Obstetrics & Gynecology | 2500 Rocky Mountain Ave Ste 2150, Loveland, CO 80538-9004 | 2019-06-25 |
| 1922366616 | Ellie A Coonrod | Obstetrics & Gynecology | 1900 Boise Ave, Loveland, CO 80538-5004 | 2012-05-01 |
| 1841557741 | Lindsey C Bannon | Obstetrics & Gynecology | 2500 Rocky Mountain Ave Ste 2100, Loveland, CO 80538-9004 | 2012-04-16 |
| 1275823510 | Big Thompson Medical Group Inc. | Obstetrics & Gynecology | 1813 Cheyenne Ave, Loveland, CO 80538-4244 | 2011-04-07 |
| 1528357209 | Jessica Brynn Bare | Obstetrics & Gynecology | 2500 Rocky Mountain Ave, North Mob, Suite 150, Loveland, CO 80538-9004 | 2011-04-01 |
| 1386955417 | Alison Anne Dormer Cowan | Obstetrics & Gynecology | 2500 Rocky Mountain Ave Ste 2200, Loveland, CO 80538-9004 | 2010-06-23 |
| Find all providers in LOVELAND | ||||
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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.