Jay Nichols Joy (NPI# 1609121722, PAC ID# 5395000582) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PATHOLOGY.
| Nation Provider ID (NPI) | 1609121722 |
| PAC ID by PECOS | 5395000582 |
| Professional Enrollment ID | I20180516003071 |
| Full Name | Jay Nichols Joy |
| Organization Legal Name | DURANGO DERMATOLOGY AND DERMATOLOGIC SURGERY LLC |
| Address |
523 S Camino Del Rio Suite B Durango CO 81303-6853 |
| Phone Number | 9702471970 |
| Gender | M |
| Medical School | UNIVERSITY OF COLORADO SCHOOL OF MEDICINE |
| Graduation Year | 1970 |
| Primary Specialty | PATHOLOGY |
| Group Practice PAC ID | 1153375902 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 060117 | ANIMAS SURGICAL HOSPITAL, LLC |
| 061327 | SOUTHWEST MEMORIAL HOSPITAL |
| 461308 | SAN JUAN HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1011 N Mildred Rd, Cortez, CO 81321-2435 | 9705658482 | ALEX R. CUDKOWICZ, M.D.,P.C. |
| 523 S Camino Del Rio, Suite B, Durango, CO 81303-6853 | 9702471970 | DURANGO DERMATOLOGY AND DERMATOLOGIC SURGERY LLC |
| Organization Legal Name | DURANGO DERMATOLOGY AND DERMATOLOGIC SURGERY LLC |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Scott C Wickless | Dermatology | Durango Dermatology and Dermatologic Surgery LLC | 523 S Camino Del Rio, Suite B, Durango, CO 81303-6853 |
| Haley G Frazier | Physician Assistant | Durango Dermatology and Dermatologic Surgery LLC | 523 S Camino Del Rio, Suite B, Durango, CO 81303-6853 |
| Michelle Lynn Goedken | Dermatology | Durango Dermatology and Dermatologic Surgery LLC | 523 S Camino Del Rio, Suite B, Durango, CO 81303-6853 |
| Mark D Gaughan | Dermatology | Durango Dermatology and Dermatologic Surgery LLC | 523 S Camino Del Rio, Suite B, Durango, CO 81303-6853 |
| Kristin E Pogue | Physician Assistant | Durango Dermatology and Dermatologic Surgery LLC | 523 S Camino Del Rio, Suite B, Durango, CO 81303-6853 |
| Street Address |
523 S CAMINO DEL RIO SUITE B |
| City | DURANGO |
| State | CO |
| Zip | 81303-6853 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Scott C Wickless | Dermatology | Durango Dermatology and Dermatologic Surgery LLC | 523 S Camino Del Rio, Suite B, Durango, CO 81303-6853 |
| Haley G Frazier | Physician Assistant | Durango Dermatology and Dermatologic Surgery LLC | 523 S Camino Del Rio, Suite B, Durango, CO 81303-6853 |
| Michelle Lynn Goedken | Dermatology | Durango Dermatology and Dermatologic Surgery LLC | 523 S Camino Del Rio, Suite B, Durango, CO 81303-6853 |
| Mark D Gaughan | Dermatology | Durango Dermatology and Dermatologic Surgery LLC | 523 S Camino Del Rio, Suite B, Durango, CO 81303-6853 |
| Kristin E Pogue | Physician Assistant | Durango Dermatology and Dermatologic Surgery LLC | 523 S Camino Del Rio, Suite B, Durango, CO 81303-6853 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melinda Jean Jordeth | Physician Assistant | Southwest Colorado Mental Health Center Inc | 281 Sawyer Dr, Suite 100, Durango, CO 81303-3409 |
| Olive A Holmes | Clinical Social Worker | Southwest Colorado Mental Health Center Inc | 281 Sawyer Dr, Suite 100, Durango, CO 81303-3409 |
| Anne Dizenzo | Clinical Social Worker | Southwest Colorado Mental Health Center Inc | 281 Sawyer Dr, Suite 100, Durango, CO 81303-3409 |
| Peggy J Bayless | Clinical Social Worker | Southwest Colorado Mental Health Center Inc | 281 Sawyer Dr, Suite 100, Durango, CO 81303-3409 |
| Sherry L Ketner | Nurse Practitioner | Southwest Colorado Mental Health Center Inc | 281 Sawyer Dr, Suite 100, Durango, CO 81303-3409 |
| Brittany Brumfield | Clinical Social Worker | Southwest Colorado Mental Health Center Inc | 281 Sawyer Dr, Suite 100, Durango, CO 81303-3409 |
| Erick L Ireland | Physician Assistant | Southwest Colorado Mental Health Center Inc | 281 Sawyer Dr, Suite 100, Durango, CO 81303-3409 |
| Brian P Ensign | Clinical Social Worker | Southwest Colorado Mental Health Center Inc | 281 Sawyer Dr, Suite 100, Durango, CO 81303-3409 |
| Stephan J Kitson | Psychiatry | Southwest Colorado Mental Health Center Inc | 281 Sawyer Dr, Suite 100, Durango, CO 81303-3409 |
| Andrew D Rosenbach | Psychiatry | Southwest Colorado Mental Health Center Inc | 281 Sawyer Dr, Suite 100, Durango, CO 81303-3409 |
| Find all physicians in zip 81303 | |||
| City | DURANGO |
| Zip Code | 81303 |
| Specialty | PATHOLOGY |
| City + Specialty | DURANGO + PATHOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.