MS. DEBRA A DEWALL (NPI# 1689621195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689621195 |
| Entity Type | Individual |
| Full Name | MS. DEBRA A DEWALL |
| Credential | PA-C |
| Practice Address |
1675 18th Ave Ste 3 Greeley CO 80631 |
| Mailing Address |
1675 18th Ave Ste 3 Greeley CO 80631-5151 |
| Practice Telephone | 9703475780 |
| Practice Fax Number | 9703475797 |
| Mailing Telephone | 9703475780 |
| Mailing Fax Number | 9703475797 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2018-09-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1042 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 57332550 | 05 | |
| CO | MEDICARE RAILROAD CARRIER PTAN | P00944843 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2121 E Harmony Rd Unit 170, Fort Collins, CO 805283413 | 9704936337 | 9704933528 |
| 2500 Rocky Mountain Ave, Loveland, CO 805389004 | 9702037080 | 9702037085 |
| Street Address |
1675 18TH AVE STE 3 |
| City | GREELEY |
| State | CO |
| Zip Code | 80631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659993756 | Poudre Valley Medical Group, LLC | General Practice | 1675 18th Ave Ste 3, Greeley, CO 80631-5151 | 2020-05-12 |
| 1922667187 | Poudre Valley Health Care Inc. | Clinic/Center | 1675 18th Ave Ste 3, Greeley, CO 80631-5151 | 2019-06-11 |
| 1326302183 | Erica Bernhardt | Internal Medicine | 1675 18th Ave Ste 3, Greeley, CO 80631 | 2012-06-26 |
| 1275805418 | Mcr Greeley Infusion Pharmacy | Pharmacy | 1675 18th Ave Ste 3, Greeley, CO 80631-5132 | 2012-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497395743 | Marcia Martinez | Peer Specialist | 1700 N 17th Ave, Greeley, CO 80631 | 2020-01-14 |
| 1073083036 | Ryan Lawhead | Specialist/Technologist | 270 Alles Dr. D, Butler Hancock Athletic Center, Greeley, CO 80631 | 2018-12-03 |
| 1447766647 | Patricia G Ferguson | Counselor | 14272 Wcr 72, Greeley, CO 80631 | 2017-12-26 |
| 1760902662 | Robert Anthony Rexroad | Counselor | 1300 N. 17th Avenue, Greeley, CO 80631 | 2017-06-21 |
| 1326577750 | Danielle Rodriguez | Psychologist | 1300 N. 17th Ave, Greeley, CO 80631 | 2017-06-08 |
| 1790157865 | Safeway | Pharmacy | 3526 W 10th Street, Greeley, CO 80631 | 2015-10-28 |
| 1245574508 | Jayme L Clapp | Counselor | 1407 8th Ave, Greeley, CO 80631 | 2012-11-26 |
| 1114246006 | Cynthia Melissa Gitler | Emergency Medicine | Banner Health, North Colorado Medical Center, 1601 18th Street, Greenley, CO 80631 | 2010-05-18 |
| 1942438023 | Khoi Dinh Le | Surgery | 1800 15th St., Suite 200, Greeley, CO 80631 | 2009-06-26 |
| 1174760011 | Darwin James Hargrave | Counselor | 912 9th Ave., #222, Greeley, CO 80631 | 2009-01-14 |
| Find all providers in zip 80631 | ||||
| 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 |
|---|---|---|---|---|
| 1538683909 | Stacie Jackson | Physician Assistant | 6500 West 29th St Ste 106, Greeley, CO 80634 | 2017-07-27 |
| 1518319094 | Anne Margaret Stavros | Physician Assistant | 2520 W. 16th Street, Greeley, CO 80634 | 2016-07-07 |
| 1952653289 | Christopher Paul Wright | Physician Assistant | 6500 W 29th St, Suite 106, Greeley, CO 80634-8386 | 2012-10-10 |
| 1134339435 | Shawna Reeves | Physician Assistant | 2200 O St, Greeley, CO 80631-9503 | 2007-05-23 |
| 1326186065 | Cyndi R Desormeaux | Physician Assistant | 1620 25th Ave, Greeley, CO 80634-4960 | 2007-02-02 |
| 1104916923 | Colleen Ines Andrijiw | Physician Assistant | 6801 W 20th St Unit 208, Greeley, CO 80634 | 2006-10-13 |
| 1750305884 | Kimberly Townsend | Physician Assistant | 1624 17th Ave, Greeley, CO 80631-5129 | 2006-07-26 |
| 1659396984 | Stephen W Toth | Physician Assistant | 1011 39th Ave, Greeley, CO 80634-2504 | 2006-07-13 |
| 1689650574 | Alexandria Pekarek | Physician Assistant | 1551 N 17th Ave, Suite 1, Greeley, CO 80631-9400 | 2005-12-21 |
| 1245238716 | Herbert Elton Johnson | Physician Assistant | 5881 W 16th St, Suite D, Greeley, CO 80634-2910 | 2005-07-08 |
| Find all providers in GREELEY | ||||
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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.