KEVIN DOUGLAS (NPI# 1902407182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902407182 |
| Entity Type | Individual |
| Full Name | KEVIN DOUGLAS |
| Practice Address |
1012 W Abriendo Ave Pueblo CO 81004-1128 |
| Mailing Address |
41 Montebello Rd Ste 204 Pueblo CO 81001-1379 |
| Practice Telephone | 7195452746 |
| Mailing Telephone | 7195452746 |
| Mailing Fax Number | 7195454100 |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2020-11-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679936785 | Kevin Douglas | Behavioral Analyst | 3473 Cannon Way, Live Oak, CA 95953-9654 | 2016-04-05 |
| 1174020598 | Kevin Andrew Douglas | Student in an Organized Health Care Education/Training Program | 1000 Montauk Hwy, West Islip, NY 11795-4927 | 2018-04-11 |
| 1932309648 | Kevin Scott Douglas | Dentist | 1603 23rd Ave, Meridian, MS 39301-3102 | 2007-07-20 |
| 1245325778 | Kevin Michael Douglas | Internal Medicine | 6900 Georgia Ave, Nw, Washington, DC 20307 | 2006-10-03 |
| Street Address |
1012 W ABRIENDO AVE |
| City | PUEBLO |
| State | CO |
| Zip Code | 81004-1128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487617320 | William Douglas Leusink | Psychiatry & Neurology | 1012 W Abriendo Ave, Pueblo, CO 81004-1128 | 2006-04-11 |
| 1366043531 | Nicolle Mainthow | Marriage & Family Therapist | 1012 W Abriendo Ave, Pueblo, CO 81004-1128 | 2020-11-04 |
| 1790386894 | Bobbie Griffin | Counselor | 1012 W Abriendo Ave, Pueblo, CO 81004-1128 | 2020-11-04 |
| 1376144451 | Ruby Martinez | Specialist | 1012 W Abriendo Ave, Pueblo, CO 81004-1128 | 2020-11-04 |
| 1316545635 | Jessica Williams | Counselor | 1012 W Abriendo Ave, Pueblo, CO 81004-1128 | 2020-10-09 |
| 1891392759 | Health Solutions | Clinic/Center | 1012 W Abriendo Ave, Pueblo, CO 81004-1128 | 2020-10-05 |
| 1366049322 | Lisa Frazier | Social Worker | 1012 W Abriendo Ave, Pueblo, CO 81004-1128 | 2020-10-02 |
| 1851907802 | Alexis Cordova | Case Manager/Care Coordinator | 1012 W Abriendo Ave, Pueblo, CO 81004-1128 | 2020-09-16 |
| 1801402789 | Katrina Long | Counselor | 1012 W Abriendo Ave, Pueblo, CO 81004-1128 | 2020-09-16 |
| 1316555139 | Sylvia Archuleta | Counselor | 1012 W Abriendo Ave, Pueblo, CO 81004-1128 | 2020-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780155929 | Renee C Lane | Nurse Practitioner | 1925 E. Orman Ave. Ste. A109, Pueblo, CO 81004 | 2018-12-16 |
| 1215406913 | Kaiser Foundation Healthplan of Colorado | Pharmacy | 2625 W. Pueblo Blvd, Pueblo, CO 81004 | 2018-11-26 |
| 1053895532 | Rebecka Ann Reatherford | Nurse Practitioner | St Mary-corwin Medical Center, 1008 Minnequa Ave, Pueblo, CO 81004 | 2018-09-20 |
| 1124510821 | Angela M Sillas-green | Counselor | 327 Colorado Ave., Pueblo, CO 81004 | 2018-05-30 |
| 1558898569 | Alexandra R B King | Family Medicine | Southern Colorado Family Medicine, 902 Lakeview Avenue, Pueblo, CO 81004 | 2017-05-22 |
| 1578098752 | James Williams | Counselor | 414 Broadway Ave, Pueblo, CO 81004 | 2017-04-26 |
| 1740732601 | Valerie A Senger | Counselor | 635 W Corona Ave Ste 214, Pueblo, CO 81004 | 2016-10-26 |
| 1194111500 | A New Leaf Therapy, Pllc | Community/Behavioral Health | 327 Colorado Ave, Pueblo, CO 81004 | 2015-04-13 |
| 1619371671 | Mariah Mcginnis | Registered Nurse | 1232 Van Buren St., Pueblo, CO 81004 | 2014-10-20 |
| 1730593112 | Maritza Martinez | Registered Nurse | 1026 Wabriendo Ave, Pueblo, CO 81004 | 2014-06-13 |
| Find all providers in zip 81004 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790335909 | Parkview Ancillary Services | Specialist | 4100 Jerry Murphy, Pueblo, CO 81001-1046 | 2019-09-19 |
| 1225595630 | Kimberly Warfield | Specialist | 5825 W Hwy 78, Pueblo, CA 81005 | 2019-02-22 |
| 1245636810 | Meredith Peterson | Specialist | 3902 Sandalwood Ln, Suite 140, Pueblo, CO 81005-7501 | 2014-11-10 |
| 1073836029 | Karl Hapcic, Md, LLC | Specialist | 1315 S Pueblo Blvd Ste 110, Pueblo, CO 81005-2192 | 2010-03-04 |
| 1831309129 | J. Valentine Cichon, Md PC | Specialist | 312 N Prairie Ave, Pueblo, CO 81005-1371 | 2007-05-23 |
| 1124237730 | Larry Edward Terrell | Specialist | 1711 E Evans Ave, Pueblo, CO 81004-3349 | 2007-05-21 |
| 1851412134 | Southern Colorado Ent & Allergy LLC | Specialist | 3676 Parker Blvd Ste 320, Pueblo, CO 81008-2213 | 2007-04-03 |
| 1356492219 | Corwin Clinic Surgical Professional Corp | Specialist | 1925 E Orman Ave Ste A109, Pueblo, CO 81004-3555 | 2007-01-16 |
| 1841391596 | William V Watson | Specialist | 3530 Spaulding Ave, Pueblo, CO 81008-2209 | 2006-09-26 |
| 1265477046 | Camille George Azar | Specialist | 1020 Lakeview Ave, Pueblo, CO 81004-3508 | 2006-06-17 |
| Find all providers in PUEBLO | ||||
Please comment or provide details below to improve the information on KEVIN DOUGLAS.
| 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.