DR. AMY CAROL REIDHEAD (NPI# 1629574512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629574512 |
| Entity Type | Individual |
| Full Name | DR. AMY CAROL REIDHEAD |
| Credential | DC, FNP-C, BSN-RN |
| Practice Address |
2355 Canyon Blvd Ste 102 Boulder CO 80302-5652 |
| Practice Telephone | 3033901245 |
| Practice Fax Number | 3033901245 |
| Mailing Telephone | 3033901245 |
| Mailing Fax Number | 3033901245 |
| Enumeration Date | 2018-04-01 |
| Last Update Date | 2019-03-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 4468 | CO | Chiropractic Providers |
| N | 163W00000X | Registered Nurse | 0202308 | CO | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0202308 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4840 Riverbend Rd Ste 100, Boulder, CO 803012633 | 3034493777 | 3034493775 |
| Street Address |
2355 CANYON BLVD STE 102 |
| City | BOULDER |
| State | CO |
| Zip Code | 80302-5652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323347 | Aviva Naomi Bannerman | Counselor | 2299pearlst., Boulder, CO 80302 | 2020-07-22 |
| 1205480845 | Mark L Sipowicz | Counselor | 100 Arapahoe Avenue, Boulder, CO 80302 | 2019-08-01 |
| 1366909806 | Brett Adamek | Counselor | 2027 Broadway, Suite E, Boulder, CO 80302 | 2019-02-20 |
| 1124592225 | Stepheny Antrobus | Counselor | 100 Arapahoe Lane, Suite 12, Boulder, CO 80302 | 2019-01-11 |
| 1942721337 | Sasha Marvel Hope | Nutritionist | 2260 Baseline Road #102, Boulder, CO 80302 | 2017-07-06 |
| 1073045365 | Mark Shusterman | Internal Medicine | 2133 5th Street, Boulder, CO 80302 | 2017-03-28 |
| 1316489396 | Agnieszka Spuzak | Nutritionist | 1267 Fourmile Canyon Dr, Boulder, CO 80302 | 2016-11-08 |
| 1265980031 | Tanya Robertson | Physical Therapy Assistant | 1633 Grove Street, Boulder, CO 80302 | 2016-09-21 |
| 1699142380 | Libbey Occupational Therapy Services LLC | Occupational Therapist | 100 West Arapahoe Ln, Suite 12, Boulder, CO 80302 | 2015-08-28 |
| 1831597244 | Annemarie Curran Prairie | Counselor | 2505 Walnut St., Ste 303, Boulder, CO 80302 | 2014-12-17 |
| Find all providers in zip 80302 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750909099 | Ruth Ann Bentley | Nurse Practitioner | 3735 Birchwood Dr Apt 28, Boulder, CO 80304-1422 | 2020-07-13 |
| 1952948648 | Dana Scritchfield | Nurse Practitioner | 3800 Northbrook Dr, Boulder, CO 80304-1434 | 2019-12-02 |
| 1881069433 | Barbara White | Nurse Practitioner | 440 Seven Hills Dr, Boulder, CO 80302-9737 | 2015-12-08 |
| 1851794572 | Genevieve Lamancusa | Nurse Practitioner | 3450 Ash Ave, Boulder, CO 80305-3432 | 2014-10-08 |
| 1164703575 | Megan Foreman | Nurse Practitioner | 7722 Devonshire Ct, Boulder, CO 80301-4111 | 2011-08-30 |
| 1740303965 | Gloria Ruth Brisson | Nurse Practitioner | Wardenburg Health Clinic, Cb 119, Boulder, CO 80309-0001 | 2007-04-10 |
| 1083781678 | Brande Marie Ingrando | Nurse Practitioner | 1000 Alpine Ave Ste 100, Boulder, CO 80304-3409 | 2006-11-29 |
| 1356306955 | Susan Lee Benson | Nurse Practitioner | 1331 Iris Avenue, Mental Health Partners, Boulder, CO 80304-2296 | 2006-04-18 |
| 1205836848 | Theresa Fedak | Nurse Practitioner | 3145 20th St, Boulder, CO 80304-2700 | 2005-07-26 |
| 1629628177 | Edith Helena Presler | Nurse Practitioner | 2525 13th St, Boulder, CO 80304-4104 | 2019-09-17 |
| Find all providers in BOULDER | ||||
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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.