FRANK BEVACQUA (NPI# 1679562763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679562763 |
| Entity Type | Individual |
| Full Name | FRANK BEVACQUA |
| Credential | PAC |
| Practice Address |
602 Yale Pl Canon City CO 81212-4611 |
| Practice Telephone | 7192752301 |
| Practice Fax Number | 7192757048 |
| Mailing Telephone | 7192752301 |
| Mailing Fax Number | 7192757048 |
| Enumeration Date | 2005-10-20 |
| 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 | 382 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | ROCKY MOUNTAIN HEALTH PLA | 840706945034 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730439639 | Frank J. Bevacqua | Psychologist | 570 W Brown Rd, Mesa, AZ 85201-3227 | 2012-09-18 |
| Street Address |
602 YALE PL |
| City | CANON CITY |
| State | CO |
| Zip Code | 81212-4611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316934896 | Valley-wide Health Systems, Inc | Clinic/Center | 602 Yale Pl, Canon City, CO 81212-4611 | 2005-09-30 |
| 1093354680 | Gateway To Success, PC | Clinic/Center | 602 Yale Pl, Canon City, CO 81212-4611 | 2019-12-30 |
| 1033693049 | Alan Donald | Counselor | 602 Yale Pl, Canon City, CO 81212-4611 | 2018-09-17 |
| 1942710157 | Amber Irving | Counselor | 602 Yale Pl, Canon City, CO 81212-4611 | 2017-10-03 |
| 1124578257 | David W. Anderson | Counselor | 602 Yale Pl, Canon City, CO 81212-4611 | 2016-10-13 |
| 1629422290 | Gateway To Success, PC | Clinic/Center | 602 Yale Pl, Canon City, CO 81212-4611 | 2016-04-20 |
| 1952719379 | Heather Leigh Manning | Nurse Practitioner | 602 Yale Pl, Canon City, CO 81212-4611 | 2014-07-29 |
| 1043547219 | Betty Ann Krenson | Nurse Practitioner | 602 Yale Pl, Canon City, CO 81212-4611 | 2009-11-10 |
| 1871755736 | India I. Smith | Counselor | 602 Yale Pl, Canon City, CO 81212-4611 | 2008-07-01 |
| 1053479402 | Robert Joseph Bennett Jr. | Family Medicine | 602 Yale Pl, Canon City, CO 81212-4611 | 2006-12-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083212393 | Buck Jack LLC | Physical Therapist | Mountain View Core Knowledge School 890 Field Ave, Cannon City, CO 81212 | 2020-10-09 |
| 1942841374 | Glorious Works Neurotherapy | Community/Behavioral Health | 115 N 7th Street, Canon City, CO 81212 | 2019-10-07 |
| 1376046292 | Lonnie Mccarron | Social Worker | 600 Evans Rd, Fremont Correctional Facility, Canon City, CO 81212 | 2018-03-16 |
| 1487156964 | Patrick Neil Cox | Case Manager/Care Coordinator | 3239 Independence Road, Canon City, CO 81212 | 2018-03-01 |
| 1831559806 | Justin Ensinger | Counselor | 700 Four Mile Parkway, Canon City, CO 81212 | 2016-03-03 |
| 1710365713 | Amber Conover | Health Educator | 105 N 10th Street, Canon City, CO 81212 | 2015-05-11 |
| 1902073448 | Richard R Williams | Counselor | 612 Field Ave, Canon City, CO 81212 | 2008-05-14 |
| 1861662249 | Huh Inc | Hearing Instrument Specialist | 121 Justice Center Rd Ste D, Canon City, CO 81212 | 2008-03-03 |
| 1013113828 | Deborah Eileen Shock | Nurse Practitioner | 275 W Hwy 50, Canon City, CO 81212 | 2007-06-27 |
| 1245433564 | Lindsey Elizabeth Fish | Internal Medicine | 275 West Hwy 50, Colorado Territorial Correctional Facility, Canon City, CO 81212 | 2007-06-06 |
| Find all providers in zip 81212 | ||||
| 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 |
|---|---|---|---|---|
| 1144384975 | Danny Warren Englund | Physician Assistant | Hwy 50 & Evans Blvd, Canon City, CO 81212 | 2006-12-19 |
| 1013913086 | Jennifer K Button | Physician Assistant | 715 S 9th St, Canon City, CO 81212-4911 | 2005-06-24 |
| 1104822162 | Raymond J Pelland | Physician Assistant | 1335 Phay Ave, Ste D, Canon City, CO 81212-2349 | 2005-06-24 |
| 1376191569 | Jeremy Duane Johnson | Physician Assistant | 715 S 9th St, Canon City, CO 81212-4911 | 2019-08-30 |
| 1225696800 | Mary Kathryn Abraham | Physician Assistant | 715 S 9th St, Canon City, CO 81212-4911 | 2019-05-30 |
| 1770047672 | Kirsten Belle Delay-papa | Physician Assistant | 121 N 6th St, Canon City, CO 81212-3329 | 2019-01-24 |
| 1104312339 | Laura Elizabeth Kushner | Physician Assistant | 3245 E Us Highway 50, Canon City, CO 81212-9342 | 2018-07-11 |
| 1023510948 | Megan Emma Southward | Physician Assistant | 3245 E Us Highway 50 Unit E, Canon City, CO 81212-9343 | 2018-03-07 |
| 1710371604 | Briseida Romero Alejandre | Physician Assistant | 1338 Phay Ave, Canon City, CO 81212-2311 | 2015-03-27 |
| 1952613317 | Eve Noel Schoenefeld | Physician Assistant | 933 Sell Ave, Canon City, CO 81212-4929 | 2010-07-13 |
| Find all providers in CANON CITY | ||||
| City | CANON CITY |
| Zip Code | 81212 |
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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.