ROCKY MOUNTAIN REGENERATIVE MEDICINE, PLLC (NPI# 1871068528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871068528 |
| Entity Type | Organization |
| Organization Name | ROCKY MOUNTAIN REGENERATIVE MEDICINE, PLLC |
| Practice Address |
2260 Baseline Rd Ste 102 Boulder CO 80302-7740 |
| Practice Telephone | 7207391616 |
| Mailing Telephone | 7207391616 |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2018-10-09 |
| Authorized Official Name | KHOSHAL LATIFZAI (PARTNER) |
| Authorized Official Telephone | 7207391616 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
2260 BASELINE RD STE 102 |
| City | BOULDER |
| State | CO |
| Zip Code | 80302-7740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881244267 | Lauren Marie Capone | Nutritionist | 2260 Baseline Rd Ste 102, Boulder, CO 80302-7740 | 2019-09-17 |
| 1881250439 | Megan Arel | Nutritionist | 2260 Baseline Rd Ste 102, Boulder, CO 80302-7740 | 2019-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323347 | Aviva Naomi Bannerman | Counselor | 2299pearlst., Boulder, CO 80302 | 2020-07-22 |
| 1205480845 | Mark L Sipowicz | Counselor | 100 Arapahoe Avenue, Boulder, CO 80302 | 2019-08-01 |
| 1366909806 | Brett Adamek | Counselor | 2027 Broadway, Suite E, Boulder, CO 80302 | 2019-02-20 |
| 1124592225 | Stepheny Antrobus | Counselor | 100 Arapahoe Lane, Suite 12, Boulder, CO 80302 | 2019-01-11 |
| 1942721337 | Sasha Marvel Hope | Nutritionist | 2260 Baseline Road #102, Boulder, CO 80302 | 2017-07-06 |
| 1073045365 | Mark Shusterman | Internal Medicine | 2133 5th Street, Boulder, CO 80302 | 2017-03-28 |
| 1316489396 | Agnieszka Spuzak | Nutritionist | 1267 Fourmile Canyon Dr, Boulder, CO 80302 | 2016-11-08 |
| 1265980031 | Tanya Robertson | Physical Therapy Assistant | 1633 Grove Street, Boulder, CO 80302 | 2016-09-21 |
| 1699142380 | Libbey Occupational Therapy Services LLC | Occupational Therapist | 100 West Arapahoe Ln, Suite 12, Boulder, CO 80302 | 2015-08-28 |
| 1831597244 | Annemarie Curran Prairie | Counselor | 2505 Walnut St., Ste 303, Boulder, CO 80302 | 2014-12-17 |
| Find all providers in zip 80302 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841548674 | Edward Cosgriff | General Practice | 5920 Longbow Dr, Boulder, CO 80301-3202 | 2012-08-28 |
| 1164790994 | Mary Dan Eades | General Practice | 6525 Gunpark Dr # 150-504, Boulder, CO 80301-3346 | 2011-12-07 |
| 1376872259 | Richard Steinberg | General Practice | 2939 10th St, Boulder, CO 80304-3019 | 2009-12-23 |
| 1669023495 | Jordan Urban | General Practice | 703 Walnut St, Boulder, CO 80302-5032 | 2019-09-23 |
| 1326396599 | Michael Robert Eades | General Practice | 6525 Gunpark Dr # 150-504, Boulder, CO 80301-3346 | 2012-08-20 |
| 1871735381 | Teresa Rebibo Fox | General Practice | 4840 Riverbend Rd, 100, Boulder, CO 80301-2659 | 2009-03-30 |
| 1932340494 | Larry Eckstein, M.d., P.C. | General Practice | 2760 29th St, Suite 2-d, Boulder, CO 80301-1214 | 2009-03-13 |
| 1649497066 | Diana L Wetzbarger | General Practice | 580 Mohawk Dr, Boulder, CO 80303-3712 | 2007-04-19 |
| 1902962939 | Gary Bruce Clark | General Practice | 1790 30th St, Suite 230, Boulder, CO 80301-1022 | 2006-12-27 |
| 1821000704 | Larry Eckstein | General Practice | 2760 29th St, Suite 2-d, Boulder, CO 80301-1214 | 2006-08-12 |
| Find all providers in BOULDER | ||||
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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.