MIRIAM R DIAZ (NPI# 1700241502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700241502 |
| Entity Type | Individual |
| Full Name | MIRIAM R DIAZ |
| Credential | PA-C |
| Practice Address |
1115 2nd St Fort Lupton CO 80621-1745 |
| Mailing Address |
203 S Rollie Ave Fort Lupton CO 80621-1508 |
| Practice Telephone | 3038572771 |
| Practice Fax Number | 7203229434 |
| Mailing Telephone | 3038572771 |
| Mailing Fax Number | 7203229434 |
| Enumeration Date | 2015-12-21 |
| Last Update Date | 2020-11-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA.0004500 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 68978359 | 05 | |
| CO | COLORADO MEDICAL BOARD | PA.0004500 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841846961 | Miriam Candy Diaz | Behavior Technician | 29461 Sw 169th Ave, Homestead, FL 33030-2512 | 2019-08-14 |
| 1174078760 | Miriam Madai Diaz | Nurse Practitioner | 636 Del Prado Blvd, Cape Coral, FL 33990-2668 | 2016-08-24 |
| 1184071821 | Miriam Ariana Diaz | Behavioral Analyst | 6841 Nw 173rd Dr, Q-102, Hialeah, FL 33015-5574 | 2016-05-23 |
| Street Address |
1115 2ND ST |
| City | FORT LUPTON |
| State | CO |
| Zip Code | 80621-1745 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942204698 | Barbara A Pivonka | Nurse Practitioner | 1115 2nd St, Fort Lupton, CO 80621-1745 | 2005-06-10 |
| 1255972584 | Elizabeth Gutierrez | Family Medicine | 1115 2nd St, Fort Lupton, CO 80621-1745 | 2019-10-08 |
| 1790338366 | Emily Westenberg | Physician Assistant | 1115 2nd St, Fort Lupton, CO 80621-1745 | 2019-07-22 |
| 1891259461 | Stephanie Flores | Physician Assistant | 1115 2nd St, Fort Lupton, CO 80621-1745 | 2019-01-28 |
| 1912493271 | Hannah Meyer | Physician Assistant | 1115 2nd St, Fort Lupton, CO 80621-1745 | 2018-07-10 |
| 1790235687 | Nancy Johnson Gonzalez | Physician Assistant | 1115 2nd St, Fort Lupton, CO 80621-1745 | 2016-10-04 |
| 1366801227 | Susana Gonzalez | Counselor | 1115 2nd St, Fort Lupton, CO 80621-1745 | 2016-02-19 |
| 1417332156 | Cynthia Ann Bates | Nurse Practitioner | 1115 2nd St, Fort Lupton, CO 80621-1745 | 2015-07-23 |
| 1063897734 | Zachary Arquilla | Dentist | 1115 2nd St, Fort Lupton, CO 80621-1745 | 2015-07-23 |
| 1386056257 | Kalina Ehrenreich-piot | Family Medicine | 1115 2nd St, Fort Lupton, CO 80621-1745 | 2014-05-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659741247 | Workwellness Inc | Clinic/Center | 1450 Dexter Ave, Fort Lupton, CO 80621 | 2015-09-25 |
| 1386902294 | Kathryn M. Bowker | Counselor | 260 College Ave, Fort Lupton, CO 80621 | 2012-04-27 |
| 1225241946 | Theresa S Doi | Physical Therapist | 721 4th Street, Suite B, Fort Lupton, CO 80621 | 2007-05-08 |
| 1003946450 | Terry W Williams Dc PC | Chiropractor | 331 Park Avenue, Fort Lupton, CO 80621 | 2007-03-06 |
| 1548326200 | Glenda P Walden | Counselor | 120 1st Street, Ft. Lupton, CO 80621 | 2006-12-28 |
| 1447329099 | Caring Hands Pharmacy Inc | Pharmacy | 105 Dales Place, Fort Lupton, CO 80621 | 2006-11-07 |
| 1942382023 | Ft Lupton Medical Team PC | Family Medicine | 308 Denver Ave, Fort Lupton, CO 80621 | 2006-10-19 |
| 1841393253 | Irene Margaret Holloman | Dentist | 229 Denver Ave, Fort Lupton, CO 80621 | 2006-09-07 |
| 1346575586 | North Range Behavioral Health | Clinic/Center | 145 1st St, Fort Lupton, CO 80621 | 2009-10-06 |
| 1366620775 | Terry Wade Williams | Chiropractor | 331 Park Ave, Fort Lupton, CO 80621 | 2008-02-07 |
| Find all providers in zip 80621 | ||||
| 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 |
|---|---|---|---|---|
| 1790338366 | Emily Westenberg | Physician Assistant | 1115 2nd St, Fort Lupton, CO 80621-1745 | 2019-07-22 |
| 1891259461 | Stephanie Flores | Physician Assistant | 1115 2nd St, Fort Lupton, CO 80621-1745 | 2019-01-28 |
| 1912493271 | Hannah Meyer | Physician Assistant | 1115 2nd St, Fort Lupton, CO 80621-1745 | 2018-07-10 |
| 1790235687 | Nancy Johnson Gonzalez | Physician Assistant | 1115 2nd St, Fort Lupton, CO 80621-1745 | 2016-10-04 |
| 1477527570 | Stephanie N Miller | Physician Assistant | 1115 2nd St, Fort Lupton, CO 80621-1745 | 2006-02-15 |
| 1396721429 | Brian P Boley | Physician Assistant | 1115 2nd St, Fort Lupton, CO 80621-1745 | 2005-12-20 |
| 1982680021 | Edward Hendrikson | Physician Assistant | 1115 2nd St, Fort Lupton, CO 80621-1745 | 2005-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649871518 | Emily Tracy | Physician Assistant | 172 Siesta Cir, Evergreen, CO 80439-4339 | 2020-11-05 |
| 1285234914 | Austin Ethridge | Physician Assistant | 22101 County Road 22, Hudson, CO 80642-9514 | 2020-10-30 |
| 1396345195 | Clarissa Rachael Flynn | Physician Assistant | 13795 W Kentucky Dr, Lakewood, CO 80228-3064 | 2020-10-29 |
| 1386244895 | Cheyenne M Zurfluh | Physician Assistant | 1301 Lory St, Fort Collins, CO 80524-4213 | 2020-10-26 |
| 1043819576 | Patrick Ryan Murphy | Physician Assistant | 1160 Sandstone Dr, Vail, CO 81657-4408 | 2020-10-26 |
| 1114527652 | Li Ashley Lim | Physician Assistant | 132 W B St Apt 3k, Pueblo, CO 81003-3446 | 2020-10-26 |
| 1477152957 | Erin Lynn Hellerstedt | Physician Assistant | 766 S Martin St Apt C222, Longmont, CO 80501-6493 | 2020-10-26 |
| 1962001438 | Brian Andrew Kacvinsky | Physician Assistant | 1333 E 17th Ave, Denver, CO 80218-1526 | 2020-10-25 |
| 1750980298 | Rachel Wolfe | Physician Assistant | 38 Qualla Ct, Boulder, CO 80303-3900 | 2020-10-24 |
| 1255930897 | Lee Finley-blasi | Physician Assistant | 841 Atwood St, Longmont, CO 80501-5020 | 2020-10-24 |
| Find all providers with the same taxonomy | ||||
| City | FORT LUPTON |
| Zip Code | 80621 |
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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.