PARKSIDE CT GROUP LLC (NPI# 1700839248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700839248 |
| Entity Type | Organization |
| Organization Name | PARKSIDE CT GROUP LLC |
| Practice Address |
215 Parkside Dr Colorado Springs CO 80910-3135 |
| Practice Telephone | 7194771033 |
| Practice Fax Number | 7194771037 |
| Mailing Telephone | 7194771033 |
| Mailing Fax Number | 7194771037 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. J. THOMAS CREPPS (M.D./MEMBER) |
| Authorized Official Telephone | 7194771033 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
31124 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | PHYSICIAN LICENSE | 31124 | 01 |
| Street Address |
215 PARKSIDE DR |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80910-3135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366406936 | Electrophysiology Associates, P.C. | Internal Medicine | 215 Parkside Dr, Suite 100, Colorado Springs, CO 80910-3131 | 2006-04-12 |
| 1457690141 | Dan A Cristescu Md PC | Internal Medicine | 215 Parkside Dr, Su 200, Colorado Springs, CO 80910-3131 | 2013-01-31 |
| 1437344017 | Michael E Sayers Do PC | Internal Medicine | 215 Parkside Dr, Ste 200, Colorado Springs, CO 80910 | 2007-09-07 |
| 1073708657 | Melissa T Hocate Md PC | Internal Medicine | 215 Parkside Dr, Ste 200, Colorado Springs, CO 80910 | 2007-09-07 |
| 1588748099 | Steven M Bernstein, Md, LLC | Radiology | 215 Parkside Dr, Suite 100, Colorado Springs, CO 80910-3131 | 2006-10-24 |
| 1710903117 | Megan C. Macneil, Md, P.c | Internal Medicine | 215 Parkside Dr, Ste 200, Colorado Springs, CO 80910-3131 | 2006-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952955403 | Marian Lin Mondy | Social Worker | 2909 Wellshire Blvd., Colorado Springs, CO 80910 | 2019-08-01 |
| 1538727474 | Lisa Morales | Audiologist | 3225 International Cir Ste 102, Colorado Springs, CO 80910 | 2019-06-05 |
| 1134617038 | Paul Gross | Counselor | 411 Lakewood Circle Dr, C-204-b, Colorado Springs, CO 80910 | 2018-04-25 |
| 1821502923 | Kathleen Lubos Ambros-dahilig | Dental Assistant | 2240 Gilpin Ave, Colorado Springs, CO 80910 | 2017-11-28 |
| 1508384793 | Shawn Maul | Registered Nurse | 115 S Parkside, Colorado Springs, CO 80910 | 2017-09-07 |
| 1376910521 | Kelley Elizabeth Smith Bouchard | Nurse Practitioner | 3225 International Circle Suite 220, Colorado Springs, CO 80910 | 2015-08-24 |
| 1619353430 | Dr. Steven Alan Gould Dds PC | Dentist | 2859 E. Fountain Blvd, Colorado Springs, CO 80910 | 2015-08-04 |
| 1881029155 | Francis Hammet | Chiropractor | 411 Lakewood Circle A1104, Colorado Springs, CO 80910 | 2013-09-05 |
| 1447697586 | Mcb Clinical Research Centers, LLC | Psychologist | 110 S. Parkside Drive, Colorado Springs, CO 80910 | 2013-05-30 |
| 1417206723 | Augustus Albert Edwards | Case Manager/Care Coordinator | 115 Parkside Drive, Colorado Springs, CO 80910 | 2012-08-31 |
| Find all providers in zip 80910 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275896508 | Dmitriy Rybitskiy | Surgery | 2222 N Nevada Ave Ste 5010, Colorado Springs, CO 80907-6865 | 2012-06-21 |
| 1124008032 | Joseph Thomas Crepps Jr. | Surgery | 3220 Orion Dr, Colorado Springs, CO 80906-0920 | 2006-01-18 |
| 1730794819 | Poudre Valley Medical Group, LLC | Surgery | 4110 Briargate Pkwy Ste 140, Colorado Springs, CO 80920-7836 | 2020-09-15 |
| 1477168557 | Poudre Valley Medical Group, LLC | Surgery | 1400 E Boulder St Ste 600, Colorado Springs, CO 80909-5533 | 2020-09-15 |
| 1316986060 | John Miller Conn Sr. | Surgery | 2222 N Nevada Ave, Suite 5017, Colorado Springs, CO 80907-6819 | 2006-06-06 |
| 1730130337 | Laura C Kissell | Surgery | 1400 E Boulder St Ste 600, Colorado Springs, CO 80909-5533 | 2006-05-16 |
| 1073593901 | Colorado Springs Vascular, P.C. | Surgery | 175 S Union Blvd, Suite 320, Colorado Springs, CO 80910-3113 | 2006-01-18 |
| 1427038330 | Scott Newton Hurlbert | Surgery | 1400 E Boulder St, Ste 600, Colorado Springs, CO 80909-5533 | 2006-01-18 |
| 1295715225 | Karl Paul Dittrich | Surgery | 175 S Union Blvd, Suite 320, Colorado Springs, CO 80910-3113 | 2006-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831706506 | University Physicians, Incorporated | Surgery | 13100 E Colfax Ave Ste 70, Aurora, CO 80011-5517 | 2020-09-28 |
| 1376015297 | Molly Goldstein | Surgery | 1401 Court St, Pueblo, CO 81003-2715 | 2018-12-18 |
| 1437412723 | Junior Univers | Surgery | 2643 Patterson Rd Ste 401, Grand Junction, CO 81506-1937 | 2012-06-21 |
| 1518230333 | James Gilbert Chandler | Surgery | 3721 Mountain Laurel Pl, Boulder, CO 80304-0798 | 2012-02-10 |
| 1982982567 | Benson M Powell II | Surgery | 2572 Silver Oak Ct, Grand Junction, CO 81505-1091 | 2011-07-29 |
| 1205078912 | Rafael Demarchi Malgor | Surgery | 12631 E 17th Ave # Msc312, Aurora, CO 80045-2527 | 2009-03-26 |
| 1770610735 | Thomas F Rehring | Surgery | 2045 N Franklin St Fl 3, Denver, CO 80205-5437 | 2007-02-27 |
| 1770624298 | Charles O Brantigan Md | Surgery | 2253 Downing St, Denver, CO 80205-5234 | 2007-02-09 |
| 1588717656 | Cass William Conaway | Surgery | 721 19th St, Denver, CO 80202-2500 | 2007-01-19 |
| 1053464669 | Cardiovascular and Thoracic Surgical Associates | Surgery | 1600 N Grand Ave Ste 500, Pueblo, CO 81003-2757 | 2007-01-18 |
| Find all providers with the same taxonomy | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80910 |
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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.