ALEXANDER NICHOLAS JENIK (NPI# 1891338646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1891338646 |
Entity Type | Individual |
Full Name | ALEXANDER NICHOLAS JENIK |
Credential | PA-C |
Practice Address |
2322 S Academy Blvd Colorado Springs CO 80916-2406 |
Mailing Address |
1510 Bison Ridge Dr Colorado Springs CO 80919-1541 |
Practice Telephone | 7193901727 |
Mailing Telephone | 7192717193 |
Enumeration Date | 2019-10-24 |
Last Update Date | 2019-10-24 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA.0005988 | CO | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS | 1163223 | 01 | |
CO | STATE MEDICAL LICENSE NUMBER | PA.0005988 | 01 |
Street Address |
2322 S ACADEMY BLVD |
City | COLORADO SPRINGS |
State | CO |
Zip Code | 80916-2406 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083621429 | Suzanne M Malis | Family Medicine | 2322 S Academy Blvd, Colorado Springs, CO 80916-2406 | 2006-08-01 |
1801405899 | William Paul Birch | Clinic/Center | 2322 S Academy Blvd, Colorado Springs, CO 80916-2406 | 2020-07-27 |
1902395866 | Tianna Terese Voros | Physician Assistant | 2322 S Academy Blvd, Colorado Springs, CO 80916-2406 | 2018-05-07 |
1770728867 | Kyle Matthew Volkert | Physical Therapist | 2322 S Academy Blvd, Colorado Springs, CO 80916-2406 | 2008-12-03 |
1144340498 | Ryan K Stallings | Family Medicine | 2322 S Academy Blvd, Colorado Springs, CO 80916-2406 | 2007-03-30 |
1861518110 | Bradley T Metts | Physical Therapist | 2322 S Academy Blvd, Colorado Springs, CO 80916-2406 | 2007-03-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740742022 | Andrea Corrie Akins | Counselor | 2060 Jet Wing Drive, Colorado Springs, CO 80916 | 2019-04-04 |
1538687454 | Loma Randie Haak | Doula | 2160 Bruno Cir, Colorado Springs, CO 80916 | 2017-08-30 |
1013463868 | Statewide Healthcare LLC | In Home Supportive Care | 2130 S. Academy Blvd., #103, Colorado Springs, CO 80916 | 2016-08-31 |
1437573557 | Carla Jackson | Contractor | 3410 Cochran Dr # C, Colorado Springs, CO 80916 | 2014-02-10 |
1346385986 | Occupational Health Centers of The Southwest Pa PC | Clinic/Center | 2322 S. Academy Blvd., Colorado Springs, CO 80916 | 2007-02-21 |
1457379893 | Charlene Kay Czarnecki | Nurse Practitioner | 3029 So Academy Blvd, Colorodo Springs, CO 80916 | 2006-07-17 |
1952337206 | Dillon Companies LLC | Durable Medical Equipment & Medical Supplies | 2910 S Academy Blvd, Colorado Springs, CO 80916 | 2006-06-25 |
1629599758 | Amanda M Bernheim | Counselor | 1795 Jet Wing Dr, Colorado Springs, CO 80916 | 2017-06-28 |
1710366166 | Cassandra Bright | Dental Hygienist | 5925 Lehman Dr, Colorado Springs, CO 80916 | 2015-05-19 |
1992042626 | Erica Palmer | Psychologist | 1795 Jet Wing Dr, Colorado Springs, CO 80916 | 2013-01-15 |
Find all providers in zip 80916 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851726681 | Lisa Kay Adams | Physician Assistant | 525 N Foote Ave Ste 202, Colorado Springs, CO 80909-4501 | 2013-09-11 |
1992945208 | Susan Gardiner Cump | Physician Assistant | 2940n Circle Dr, Colorado Springs, CO 80909-1160 | 2009-02-26 |
1356591762 | Johnathon D. Kupfner | Physician Assistant | 1584 Jackson Creek Parkway, Ste 120, Colorado Springs, CO 80132 | 2008-09-22 |
1427218916 | Gary Patrick Tocci | Physician Assistant | 9310 Sky King Dr, Colorado Springs, CO 80924-2020 | 2008-06-10 |
1619144888 | Laurie K Redding | Physician Assistant | 2130 Hollow Brook Dr, Suite 100, Colorado Springs, CO 80918-8400 | 2008-05-15 |
1760520746 | Donald Ray Lawson | Physician Assistant | 7667 Steward Ln, Colorado Springs, CO 80922-6327 | 2007-02-02 |
1245321140 | Kim Redinger | Physician Assistant | 1740 Pepperwood Dr, Colorado Springs, CO 80910-1525 | 2006-09-27 |
1366452401 | Kenneth L Phillips Jr. | Physician Assistant | 15026 La Jolla Pl, Colorado Springs, CO 80921-2564 | 2006-08-09 |
1770538159 | Jane D Brockhausen | Physician Assistant | 5799 Stetson Hills Blvd Ste 100, Colorado Springs, CO 80917-4223 | 2006-05-23 |
1033173851 | Michael E Young | Physician Assistant | 2222 N Nevada Ave Ste 5011, Colorado Springs, CO 80907-6819 | 2006-04-17 |
Find all providers in COLORADO SPRINGS |
City | COLORADO SPRINGS |
Zip Code | 80916 |
Please comment or provide details below to improve the information on ALEXANDER NICHOLAS JENIK.
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.