DIANA L WETZBARGER (NPI# 1649497066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649497066 |
| Entity Type | Individual |
| Full Name | DIANA L WETZBARGER |
| Practice Address |
580 Mohawk Dr Boulder CO 80303-3712 |
| Practice Telephone | 3035545185 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 74889 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KAISER-COMMERCIAL NUMBER | 015184 | 01 |
| Street Address |
580 MOHAWK DR |
| City | BOULDER |
| State | CO |
| Zip Code | 80303-3712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376529941 | Eileen G Bickford | Family Medicine | 580 Mohawk Dr, Boulder, CO 80303-3712 | 2005-12-15 |
| 1669955571 | Natalie Gonzales | Registered Nurse | 580 Mohawk Dr, Boulder, CO 80303-3712 | 2018-09-07 |
| 1578091062 | Michelle Justine Moffett | Registered Nurse | 580 Mohawk Dr, Boulder, CO 80303-3712 | 2017-05-26 |
| 1174059703 | Katherine Crumpton | Registered Nurse | 580 Mohawk Dr, Boulder, CO 80303-3712 | 2017-05-02 |
| 1699215715 | Desiree Zuniga | Registered Nurse | 580 Mohawk Dr, Boulder, CO 80303-3712 | 2017-03-08 |
| 1912456500 | David Holt | Registered Nurse | 580 Mohawk Dr, Boulder, CO 80303-3712 | 2016-09-24 |
| 1447603469 | Colorado Permanente Medical Group, P.C. | Clinic/Center | 580 Mohawk Dr, Boulder, CO 80303-3712 | 2016-07-14 |
| 1851793400 | Heidi S Gamber | Registered Nurse | 580 Mohawk Dr, Boulder, CO 80303-3712 | 2014-09-25 |
| 1518398643 | Pamela Hernandez | Registered Nurse | 580 Mohawk Dr, Boulder, CO 80303-3712 | 2013-11-27 |
| 1013359496 | Alexi Kimball Perkins | Physician Assistant | 580 Mohawk Dr, Boulder, CO 80303-3712 | 2013-07-25 |
| Find all providers in the same location | ||||
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|---|---|---|---|---|
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| 1831683838 | Sandra Ramsey | Occupational Therapist | 350 Ponca, Boulder, CO 80303 | 2018-06-22 |
| 1770085243 | Laura Michelle Boucher | Physical Medicine & Rehabilitation | 5387 Manhattan Cir, Ste 200, Boulder, CO 80303 | 2018-03-01 |
| 1396255568 | Colorado Sports Chiropractic | Chiropractor | 1440 28th St Ste 2, Boulder, CO 80303 | 2017-10-02 |
| 1932618782 | Michele Adrienne Packard | Psychologist | 4410 Arapahoe Suite 140, Boulder, CO 80303 | 2017-09-25 |
| 1134505290 | Bili Blanket Baby, LLC | Durable Medical Equipment & Medical Supplies | 4450 Arapahoe Ave, Suite 100, Boulder, CO 80303 | 2015-07-30 |
| 1710378146 | Jonathan Gardiner Lears | Counselor | 5600 Arapahoe Ave, Suite 102, Boulder, CO 80303 | 2015-02-06 |
| 1114316965 | Northstar Transitions | Substance Abuse Rehabilitation Facility | 75 Manhattan Dr., Suites 110 and 208 Northstar Transitions, Boulder, CO 80303 | 2015-01-16 |
| 1902226434 | Integrated Dermatology of Boulder, Pllc | Dermatology | 2935 Baseline Road, Suite 201, Boulder, CO 80303 | 2014-04-23 |
| 1396160081 | Melissa Rupert | Physical Therapist | 975 Waite Drive, Boulder, CO 80303 | 2014-03-04 |
| Find all providers in zip 80303 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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|---|---|---|---|---|
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| 1164790994 | Mary Dan Eades | General Practice | 6525 Gunpark Dr # 150-504, Boulder, CO 80301-3346 | 2011-12-07 |
| 1376872259 | Richard Steinberg | General Practice | 2939 10th St, Boulder, CO 80304-3019 | 2009-12-23 |
| 1669023495 | Jordan Urban | General Practice | 703 Walnut St, Boulder, CO 80302-5032 | 2019-09-23 |
| 1326396599 | Michael Robert Eades | General Practice | 6525 Gunpark Dr # 150-504, Boulder, CO 80301-3346 | 2012-08-20 |
| 1871735381 | Teresa Rebibo Fox | General Practice | 4840 Riverbend Rd, 100, Boulder, CO 80301-2659 | 2009-03-30 |
| 1932340494 | Larry Eckstein, M.d., P.C. | General Practice | 2760 29th St, Suite 2-d, Boulder, CO 80301-1214 | 2009-03-13 |
| 1902962939 | Gary Bruce Clark | General Practice | 1790 30th St, Suite 230, Boulder, CO 80301-1022 | 2006-12-27 |
| 1821000704 | Larry Eckstein | General Practice | 2760 29th St, Suite 2-d, Boulder, CO 80301-1214 | 2006-08-12 |
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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.