SHELBY SUBRY


Address: 400 W 16th St, Pueblo, CO 81003-2745
Phone: 9705844000

SHELBY SUBRY (NPI# 1669033973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1669033973
Entity Type Individual
Full Name SHELBY SUBRY
Credential PA-C
Practice Address 400 W 16th St
Pueblo
CO 81003-2745
Mailing Address 1954 Jamison Dr
Fort Collins
CO 80528-6365
Practice Telephone 9705844000
Enumeration Date 2019-06-26
Last Update Date 2020-10-07
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
PA.0006160 CO Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
1954 Jamison Dr, Fort Collins, CO 805286365 9703056860

Office Location

Street Address 400 W 16TH ST
City PUEBLO
State CO
Zip Code 81003-2745

Providers in the same location

NPI Name Taxonomy Address Enumeration
1992700694 James E Caldwell Anesthesiology 400 W 16th St, Pueblo, CO 81003-2745 2005-06-17
1174137806 Pediatrix Medical Group of Colorado, P.C. Pediatrics 400 W 16th St, Pueblo, CO 81003-2745 2020-09-01
1992327217 Kristina Reavis Nurse Practitioner 400 W 16th St, Pueblo, CO 81003-2781 2020-05-08
1881214567 Nathan S Grigg Student in an Organized Health Care Education/Training Program 400 W 16th St, Pueblo, CO 81003-2745 2020-04-22
1467083881 Erik Matthews Wickstrum Nurse Anesthetist, Certified Registered 400 W 16th St, Pueblo, CO 81003-2781 2020-02-04
1497385082 Sean Jastillano Nurse Anesthetist, Certified Registered 400 W 16th St, Pueblo, CO 81003-2745 2020-01-22
1417597287 Zainab Adeyemo Nurse Anesthetist, Certified Registered 400 W 16th St, Pueblo, CO 81003-2745 2020-01-09
1265071658 Victoria Louise Farnsworth Nurse Anesthetist, Certified Registered 400 W 16th St, Pueblo, CO 81003-2781 2020-01-02
1205479557 Brandis Courtney Montez Nurse Practitioner 400 W 16th St, Pueblo, CO 81003-2781 2019-10-18
1750923199 Catholic Health Initiatives Colorado Thoracic Surgery (Cardiothoracic Vascular Surgery) 400 W 16th St, Pueblo, CO 81003-2745 2019-10-16
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1164042016 Sunil Kumar Student in an Organized Health Care Education/Training Program Parkview Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 2020-04-21
1497382303 Pueblo Family Dentistry Pllc Dentist 701 N Grand Avenue, Suite B, Pueblo, CO 81003 2020-03-23
1023654241 Elmer A. Villalon, Dmd, LLC Clinic/Center 1225 North Main Street, #207, Pueblo, CO 81003 2019-11-22
1518434349 Mariam Rahim Internal Medicine Parkview Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 2018-10-30
1003308222 Julia Mcneice Internal Medicine Parkview Medial Center, Parkveiw Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 2018-06-04
1689164857 Jessica Sels Internal Medicine Parkview Medical Center Adult Medicine Clinic, 311 W 14th St, Pueblo, CO 81003 2018-05-14
1700313459 Allison Vigil Occupational Therapist 1600 W. 24th St, Pueblo, CO 81003 2017-05-12
1245682020 Paul S Bongat Internal Medicine 411 W. 14th St., Parkview Adult Medicine Clinic, Pueblo, CO 81003 2016-07-06
1013368596 Daniel R Long Internal Medicine 411 West 14th Street, Pueblo, CO 81003 2016-06-27
1396195665 Parkview Medical Center General Acute Care Hospital 411 W. 14th St, Pueblo, CO 81003 2016-06-17
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1356685747 Dayna Rae Hochevar Physician Assistant 602 Brown Ave, Pueblo, CO 81004 2012-11-26
1164584686 Michael S Walsh Physician Assistant 3116 N. Elizabeth, Pueblo, CO 81008 2006-12-14
1003342981 Vi T Pham Physician Assistant 1080 Chinook Ln, Pueblo, CO 81001-1850 2017-05-11
1679922777 Gary Anthony Serravo Physician Assistant 400 W 16th St, Pueblo, CO 81003-2745 2016-06-09
1588057319 James Richard Anderson Physician Assistant 3676 Parker Blvd, Pueblo, CO 81008-2212 2015-03-18
1285040196 Brittany Stadterman Physician Assistant 300 Colorado Ave, Pueblo, CO 81004-2006 2014-07-11
1023342961 Juan Carlos Herraez Sanchez Physician Assistant 1008 Minnequa Ave, Pueblo, CO 81004-3733 2009-09-24
1083869754 Ginger Rae Todd Physician Assistant 300 Colorado Ave, Pueblo, CO 81004-2006 2008-11-22
1093982647 Nancy Waller Physician Assistant 1339 S Pueblo Blvd, Pueblo, CO 81005-1508 2008-05-13
1659542926 Marc A Williams Physician Assistant 1600 N Grand Ave Ste 310, Pueblo, CO 81003-2729 2008-03-14
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Competitor

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City PUEBLO
Zip Code 81003

Improve Information

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Dataset Information

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.

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