LARRY D TICE (NPI# 1942213475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942213475 |
| Entity Type | Individual |
| Full Name | LARRY D TICE |
| Credential | MD |
| Practice Address |
551 Kokopelli Blvd Suite I Fruita CO 81521-6305 |
| Mailing Address |
551 Kokopelli Blvd Unit I Fruita CO 81521-6305 |
| Practice Telephone | 9708582580 |
| Practice Fax Number | 9708583211 |
| Mailing Telephone | 9708582580 |
| Mailing Fax Number | 9708583211 |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2014-04-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 18565 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 01185651 | 05 |
| Street Address |
551 KOKOPELLI BLVD SUITE I |
| City | FRUITA |
| State | CO |
| Zip Code | 81521-6305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700870680 | Lynda Sue Hamner | Physical Medicine & Rehabilitation | 551 Kokopelli Blvd, Ste J, Fruita, CO 81521-6305 | 2005-09-07 |
| 1487291225 | Community Medical Group, LLC | Family Medicine | 551 Kokopelli Blvd, Fruita, CO 81521-6305 | 2019-11-27 |
| 1982169272 | Lisa Draminski | Speech-Language Pathologist | 551 Kokopelli Blvd, Fruita, CO 81521-6305 | 2019-01-31 |
| 1427284470 | Psych On Heels | Nurse Practitioner | 551 Kokopelli Blvd, Fruita, CO 81521-6305 | 2009-06-04 |
| 1285776864 | Kenneth C Lewis | Anesthesiology | 551 Kokopelli Blvd, Suite K, Fruita, CO 81521-6305 | 2007-02-12 |
| 1891895389 | Thomas Scruton | Physician Assistant | 551 Kokopelli Blvd, Fruita, CO 81521-6305 | 2006-09-24 |
| 1528010527 | Angela K Gao | Family Medicine | 551 Kokopelli Blvd, Suite F, Fruita, CO 81521-6305 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669070306 | Lower Valley Hospital Association | Psychiatry & Neurology | 551 Kokopelli Blvd Unit G, -practice Location Npi Only-, Fruita, CO 81521 | 2020-10-14 |
| 1215535943 | Lower Valley Hospital Association | Clinic/Center | 576 Kokopelli Blvd Unit F, -practice Location Npi Only-, Fruita, CO 81521 | 2020-10-14 |
| 1851883284 | Rivers End Dental | Clinic/Center | 532 Raptor Road, Unit B, Fruita, CO 81521 | 2018-06-01 |
| 1427404789 | Path-co, LLC | Day Training, Developmentally Disabled Services | 113 Elderberry Drive, Fruita, CO 81521 | 2016-05-05 |
| 1043518822 | Jonathan E Blaha | Chiropractor | 212 E. Aspen Ave, Fruita, CO 81521 | 2011-03-03 |
| 1881916401 | Diana L Wright | Physician Assistant | 456 Kokopelli Blvd, Suite B, Fruita, CO 81521 | 2010-02-23 |
| 1881878759 | Elizabeth Arena Rook | Internal Medicine | 576 Kokopelli Blvd Unit D-e, Fruita, CO 81521 | 2007-12-27 |
| 1073715348 | Milton Bret Mixon | Speech-Language Pathologist | 551 Kokopelli Blvd Unit B, Fruita, CO 81521 | 2007-05-31 |
| 1306063748 | Scott Douglas Lybrook | Dentist | 551 Kokopelli Blvd, Suite A, Fruita, CO 81521 | 2007-04-19 |
| 1316060684 | Carol Bell Lybrook | Dentist | 551 Kokopelli Ave.,suite A, Fruita, CO 81521 | 2007-04-09 |
| Find all providers in zip 81521 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396358578 | Scl Health Medical Group - Grand Junction, LLC | Neurological Surgery | 350 Market St Unit 1, Basalt, CO 81621-7410 | 2020-08-26 |
| 1154933786 | Neurosurgery One PC | Neurological Surgery | 9695 S Yosemite St Ste 377, Lone Tree, CO 80124-2826 | 2020-08-17 |
| 1477180255 | Healthone Clinic Services - Surgery Neurological LLC | Neurological Surgery | 1721 E 19th Ave Ste 500, Denver, CO 80218-1242 | 2020-03-24 |
| 1497382246 | Neurosurgery One PC | Neurological Surgery | 9397 Crown Crest Blvd Ste 411, Parker, CO 80138-8789 | 2020-03-23 |
| 1013543891 | Scl Health Medical Group - Denver, LLC | Neurological Surgery | 3455 Lutheran Pkwy Ste 285, Wheat Ridge, CO 80033-6034 | 2020-03-12 |
| 1598300790 | Valley View Hospital Association | Neurological Surgery | 0377 Sylvan Lake Rd, Eagle, CO 81631-0129 | 2019-11-12 |
| 1194369926 | Valley View Hospital Association | Neurological Surgery | 350 Market St Unit 200, Basalt, CO 81621-7403 | 2019-11-05 |
| 1326565177 | Fredric M Sonstein Md Mba Pllc | Neurological Surgery | 333 W Hampden Ave Ste 800, Englewood, CO 80110 | 2017-08-23 |
| 1447773601 | Edin Nevzati | Neurological Surgery | 665 Clermont St, Denver, CO 80220-5023 | 2017-07-19 |
| 1306385752 | Resilience Surgical LLC | Neurological Surgery | 99 Inverness Dr E Ste 100, Englewood, CO 80112-5127 | 2017-02-17 |
| 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.