DAMIAN GRADISAR (NPI# 1588107098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588107098 |
| Entity Type | Individual |
| Full Name | DAMIAN GRADISAR |
| Credential | ACNP |
| Practice Address |
1919 W Us Highway 50 Pueblo CO 81008-1618 |
| Practice Telephone | 7192537102 |
| Practice Fax Number | 7192537114 |
| Mailing Telephone | 7192537102 |
| Mailing Fax Number | 7192537114 |
| Enumeration Date | 2016-12-01 |
| Last Update Date | 2017-03-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
APN0992783NP | CO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1919 W US HIGHWAY 50 |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008-1618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174593081 | Lance R. Farnworth | Orthopaedic Surgery | 1919 W Us Highway 50, Pueblo, CO 81008-1618 | 2006-01-24 |
| 1255890679 | Michelle Renee Diiorio | Technician, Other | 1919 W Us Highway 50, Pueblo, CO 81008-1618 | 2019-03-15 |
| 1477002020 | Nathan Gasper | Nurse Practitioner | 1919 W Us Highway 50, Pueblo, CO 81008 | 2016-09-23 |
| 1568534642 | Pueblo Bone and Joint Clinic LLC | Orthopaedic Surgery | 1919 W Us Highway 50, Pueblo, CO 81008-1618 | 2006-11-14 |
| 1790755056 | Matthew P. Simonich | Orthopaedic Surgery | 1919 W Us Highway 50, Pueblo, CO 81008-1618 | 2006-01-26 |
| 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 |
| Find all providers in zip 81008 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679104244 | Nicole Bartolo | Nurse Practitioner | 2152 Gale Rd, Pueblo, CO 81006-1933 | 2020-01-31 |
| 1053895532 | Rebecka Ann Reatherford | Nurse Practitioner | St Mary-corwin Medical Center, 1008 Minnequa Ave, Pueblo, CO 81004 | 2018-09-20 |
| 1518206531 | Christopher Dean Trujillo | Nurse Practitioner | 111 W Evans Ave, Pueblo, CO 81004 | 2013-02-11 |
| 1558554188 | Gregory Charles Grahek | Nurse Practitioner | 1925 E Orman Ave Ste A535, Pueblo, CO 81004-3559 | 2007-08-27 |
| 1780703421 | Anna Mae Martinez | Nurse Practitioner | 416 Colorado Ave, Pueblo, CO 81004-2011 | 2007-03-27 |
| 1447319363 | Rose Wertz | Nurse Practitioner | 1925 E Orman Ave Ste A235, Pueblo, CO 81004-3556 | 2006-12-06 |
| 1992327217 | Kristina Reavis | Nurse Practitioner | 400 W 16th St, Pueblo, CO 81003-2781 | 2020-05-08 |
| 1730657636 | Marquez Family Medicine, Ltd. | Nurse Practitioner | 1910 Lake Ave, Pueblo, CO 81004-3322 | 2018-11-08 |
| 1790253128 | Amber Doss | Nurse Practitioner | 3670 Parker Blvd, Pueblo, CO 81008-2285 | 2018-11-03 |
| 1346718855 | Jamison Robert Lester | Nurse Practitioner | 400 W 16th St, Pueblo, CO 81003-2781 | 2018-11-02 |
| Find all providers in PUEBLO | ||||
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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.