EDWARD MEDINA (NPI# 1558351460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558351460 |
| Entity Type | Individual |
| Full Name | EDWARD MEDINA |
| Credential | PAC |
| Practice Address |
1710 1st St Alamosa CO 81101-2302 |
| Practice Telephone | 7195893658 |
| Practice Fax Number | 7195890997 |
| Mailing Telephone | 7195893658 |
| Mailing Fax Number | 7195890997 |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1115 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | ROCKY MOUNTAIN HEALTH PLA | 840706945169 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770525719 | Edward O Medina | Surgery | 1960 Ogden St Ste 550, Denver, CO 80218-1022 | 2006-06-12 |
| 1538624432 | Edward Medina | Nurse Practitioner | 816 S 5th St Ste B, Montrose, CO 81401-5765 | 2019-02-05 |
| 1285861211 | Edward C Medina | Military Health Care Provider | Rr 2 Box 5425, Camp Bullis, San Antonio, TX 78257-0000 | 2009-06-17 |
| 1700060647 | Edward A. Medina | Pathology | 4502 Medical Dr, San Antonio, TX 78229-4402 | 2007-12-27 |
| 1063600989 | Edward Martin Medina | Case Manager/Care Coordinator | 2151 College Ave, Bakersfield, CA 93305 | 2007-10-04 |
| 1902010572 | Edward Medina | Social Worker | 3302 Steuben Ave, Bronx, NY 10467-2806 | 2007-05-10 |
| 1619910080 | Edward Robles Medina | Anesthesiology | 516 E. Nizhoni Blvd, Gallup, NM 87301-1337 | 2006-06-14 |
| Street Address |
1710 1ST ST |
| City | ALAMOSA |
| State | CO |
| Zip Code | 81101-2302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801883459 | Valley-wide Health Systems, Inc | Clinic/Center | 1710 1st St, Alamosa, CO 81101-2302 | 2005-09-29 |
| 1245838663 | Brandon Fritz | Pharmacist | 1710 1st St, Alamosa, CO 81101-2302 | 2020-10-16 |
| 1225338767 | Valley Wide Health Services, Inc | Pharmacist | 1710 1st St, Alamosa, CO 81101-2302 | 2010-11-01 |
| 1689984924 | Eric Wolfe | Pharmacist | 1710 1st St, Alamosa, CO 81101-2302 | 2010-10-20 |
| 1659681195 | Jordan Scott Ricard | Pharmacist | 1710 1st St, Alamosa, CO 81101-2302 | 2010-10-18 |
| 1538492277 | Justin L Hanel | Pharmacist | 1710 1st St, Alamosa, CO 81101-2302 | 2009-09-14 |
| 1760685580 | Tammy R. Gregg | Family Medicine | 1710 1st St, Alamosa, CO 81101-2302 | 2007-06-08 |
| 1750364774 | Valley-wide Health Systems,inc | Clinic/Center | 1710 1st St, Alamosa, CO 81101-2302 | 2005-11-23 |
| 1013908953 | James Michael Crownover | Nurse Practitioner | 1710 1st St, Alamosa, CO 81101-2302 | 2005-10-31 |
| 1366432379 | Joann Kunugi | Physician Assistant | 1710 1st St, Alamosa, CO 81101-2302 | 2005-10-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962909325 | Tiffanie Nicole Hoover | Nurse Practitioner | Slv Health, 106 Blanca Ave, Alamosa, CO 81101 | 2018-04-11 |
| 1629503669 | Early Oral Health Interception LLC | Dental Hygienist | 235 Carson Avenue, Alamosa, CO 81101 | 2017-04-27 |
| 1477917391 | Mary Sawyer | Nurse Practitioner | San Luis Valley Health106 Blanca Ave, Alamosa, CO 81101 | 2016-04-06 |
| 1508221276 | Kendal W Humes | Counselor | 1460 W 8th Street, Unit 13, Alamosa, CO 81101 | 2015-12-23 |
| 1689096422 | Julia Toczek | Counselor | 8745 County Road 9s, Alamosa, CO 81101 | 2014-01-14 |
| 1275883365 | Michelle Marie Craver | Counselor | 8745 County Road 9 South, Alamosa, CO 81101 | 2012-09-15 |
| 1417193079 | Slv Eye Docs, LLC | Optometrist | 706 Del Sol Dr, Alamosa, CO 81101 | 2008-12-31 |
| 1770753154 | Huh Inc | Hearing Instrument Specialist | 2101 Main St., Ste C Ears 2 U Hearing Aid Services, Alamosa, CO 81101 | 2008-03-03 |
| 1215139613 | Valley-wide Health System, Inc. | Pharmacist | 1710 1st Street, Alamosa, CO 81101 | 2007-06-05 |
| 1821204116 | Valerie Stephanie Gurule-duran | Counselor | 8745 Cr 9 South, Alamosa, CO 81101 | 2007-05-15 |
| Find all providers in zip 81101 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013907013 | Edward Kulp | Physician Assistant | 2115 Stuart Ave, Alamosa, CO 81101-2269 | 2005-10-21 |
| 1073165486 | Amy Nicole Blakeslee | Physician Assistant | 2115 Stuart Ave, Alamosa, CO 81101-2269 | 2019-07-15 |
| 1629572821 | Brendan Simenc | Physician Assistant | 106 Blanca Ave, Alamosa, CO 81101-2340 | 2018-03-21 |
| 1003220930 | Sadie Thomas | Physician Assistant | 2115 Stuart Ave, Alamosa, CO 81101-2269 | 2014-06-18 |
| 1487088852 | Luis Fernando Hernandez | Physician Assistant | 128 Market St, Alamosa, CO 81101-2290 | 2013-08-21 |
| 1407056682 | Amanda Louise Schultz | Physician Assistant | 2115 Stuart Ave, Alamosa, CO 81101-2269 | 2007-07-24 |
| 1134225592 | Botond A Vita | Physician Assistant | 2115 Stuart Ave, Alamosa, CO 81101-2269 | 2006-09-15 |
| 1790791051 | Susan J Macaskill | Physician Assistant | 128 Market St, Alamosa, CO 81101-2290 | 2006-07-31 |
| 1336122894 | Howard William Cox | Physician Assistant | 106 Blanca Ave, Alamosa, CO 81101-2340 | 2005-11-29 |
| 1093705857 | Johnny B Sisneros | Physician Assistant | 106 Blanca Ave Ste 300, Alamosa, CO 81101-2340 | 2005-10-24 |
| Find all providers in ALAMOSA | ||||
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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.