MR. DALE A SPENCE (NPI# 1750441440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750441440 |
| Entity Type | Individual |
| Full Name | MR. DALE A SPENCE |
| Credential | PA-C |
| Practice Address |
Evans Army Comunity Hospital Premier Medical Home Ft Carson CO 80913-4604 |
| Mailing Address |
Evans Army Comunity Hospital (each) Usa 1650 Cochrane Cir Attn Credentials Office Ft Carson CO 80913-4604 |
| Practice Telephone | 7195247601 |
| Practice Fax Number | 7195243526 |
| Mailing Telephone | 7195267844 |
| Mailing Fax Number | 7195267984 |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2015-06-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA01722 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
2430 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
EVANS ARMY COMUNITY HOSPITAL PREMIER MEDICAL HOME |
| City | FT CARSON |
| State | CO |
| Zip Code | 80913-4604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326651498 | Christopher M Juneau | Physical Therapist | Us Air Force/ Fort Carson, 8420 Skyraider Rd, Colorado Springs, AA 80913 | 2020-08-28 |
| 1003433640 | Denise Marie Cacho | Dentist | Smith Dental Clinic, 2280 Hogan St. Blgd 1561, Fort Carson, CO 80913 | 2020-06-30 |
| 1497378053 | Ivan Sergeyevich Koutsopatriy | Dentist | Us Army Dental Health Activity 1667 Cochrane Circle, Bldg 7495, Fort Carson, CO 80913 | 2020-05-18 |
| 1396293478 | Kayla Howerton | Audiologist | 8901 Wetzel Ave, Bldg 1525, Fort Carson, CO 80913 | 2016-09-16 |
| 1922472125 | Danell Pugh | Social Worker | Bldg 1657, Fort Carson, CO 80913 | 2015-11-25 |
| 1750761136 | Colin Michael Kenny | Internal Medicine | Evans Army Community Hospital. 1650 Cochrane Cir B7500, Fort Carson, CO 80913 | 2015-06-01 |
| 1740689736 | Rachel Edwards | Speech-Language Pathologist | Evans Community Hospital, 1650 Cochrane Circle, Fort Carson, CO 80913 | 2014-08-15 |
| 1841617859 | Douglas Foote | Social Worker | 1657 Prussman, Ft. Carson, CO 80913 | 2014-03-27 |
| 1649619396 | Brigette Marie Grimes | Dietitian, Registered | Building 1435, 4th Infantry Division, Division Surgeon, Fort Carson, CO 80913 | 2013-06-17 |
| 1467895318 | Evans Army Community Hospital | Clinic/Center | Bldg 2361 Titus Blvd, Ft Carson, CO 80913 | 2013-04-10 |
| Find all providers in zip 80913 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194768713 | Connie Welch | Physician Assistant | 3 Acr Medical Troop Support Squadron, Bldg 1650 Barkley Road, Ft Carson, CO 80913 | 2006-06-13 |
| 1477691657 | Lon Grant Kirt | Physician Assistant | 1650 Cochrane Cir, Ft Carson, CO 80913-4603 | 2007-02-01 |
| 1831164425 | Joseph H. Kubicek | Physician Assistant | 1650 Cochrane Cir, Ft Carson, CO 80913-4603 | 2006-02-17 |
| 1144294364 | Nelson A Sawyer | Physician Assistant | 1650 Cochrane Cir, Ft Carson, CO 80913-4603 | 2006-02-14 |
| 1811976079 | Chester Steven Sullivan | Physician Assistant | 1650 Cochrane Cir, Ft Carson, CO 80913-4603 | 2006-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677240 | Monique Minter | Physician Assistant | 5504 Malta St, Denver, CO 80249-8649 | 2020-10-23 |
| 1700430261 | Brianne Tanae Harper | Physician Assistant | 2530 N 8th St Suite 205, Grand Junction, CO 81501 | 2019-08-01 |
| 1013478445 | Robin Elise Feldman | Physician Assistant | 17033 E Dorado Dr, Centennial, CO 80015-3029 | 2019-03-28 |
| 1780141895 | Wendy Mc Bui | Physician Assistant | 1530 S Florence Way Unit 312, Aurora, CO 80247 | 2019-02-25 |
| 1639650252 | Jade Golden | Physician Assistant | 101 Founders Pl Ste 109, Aspen, CO 81611-1476 | 2018-08-22 |
| 1861902157 | Hannah Ellen Martin | Physician Assistant | Children's Hospital Colorado 13123 East 16th Avenue, Box 060, Aurora, CO 80045-0600 | 2017-10-02 |
| 1861901878 | Stephanie J Dyck IIi | Physician Assistant | 3800 North York St, Denver, CO 80205-3540 | 2017-09-21 |
| 1932622719 | Brooke Annette Albert | Physician Assistant | 2801 Youngfield St Ste 150, Golden, CO 80401-0209 | 2017-07-24 |
| 1912433400 | Wendy Miller | Physician Assistant | 4041 E Forbes Ct, Greenwood Village, CO 80121-3943 | 2017-05-03 |
| 1154863249 | Zachary A Hitchcock | Physician Assistant | 1107 S Lemay Ave Ste 240, Fort Collins, CO 80524-3959 | 2016-11-07 |
| Find all providers with the same taxonomy | ||||
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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.