Connor Roman Longacre (NPI# 1154813673, PAC ID# 7012263072) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
| Nation Provider ID (NPI) | 1154813673 |
| PAC ID by PECOS | 7012263072 |
| Professional Enrollment ID | I20180705000234 |
| Full Name | Connor Roman Longacre |
| Organization Legal Name | AXIS SPORTS MEDICINE LLC |
| Address |
142 Beaver Creek Place Unit 109 Avon CO 81620 |
| Phone Number | 9707909600 |
| Gender | M |
| Graduation Year | 2018 |
| Primary Specialty | PHYSICAL THERAPY |
| Group Practice PAC ID | 7214188895 |
| Number of Group Practice Members | 20 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 142 Beaver Creek Place, Unit 109, Avon, CO 81620 | 9707909600 | AXIS SPORTS MEDICINE LLC |
| 660 Golden Ridge Rd, Suite 250, Golden, CO 80401-9541 | 3032331223 | PANORAMA ORTHOPEDICS AND SPINE CENTER PC |
| Organization Legal Name | AXIS SPORTS MEDICINE LLC |
| Physicians | 24 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brady D Baker | Physical Therapy | Axis Sports Medicine LLC | 1143 Capitol St, Unit 102b, Eagle, CO 81631-5000 |
| Barbara D Thomas | Physical Therapy | Axis Sports Medicine LLC | 122 S Main St, Suite D, Breckenridge, CO 80424 |
| Jennifer V Gotantas | Physical Therapy | Axis Sports Medicine LLC | 710 N Summit Blvd, Suite 103, Frisco, CO 80443 |
| Shannon M Irish | Physical Therapy | Axis Sports Medicine LLC | 142 Beaver Creek Place, Unit 109, Avon, CO 81620 |
| Kimberly Eytel | Physical Therapy | Axis Sports Medicine LLC | 122 S Main St, Suite D, Breckenridge, CO 80424 |
| Sean P Juarez | Physical Therapy | Axis Sports Medicine LLC | 142 Beaver Creek Place, Unit 109, Avon, CO 81620 |
| Gentian Nuzzo | Physical Therapy | Axis Sports Medicine LLC | 142 Beaver Creek Place, Unit 109, Avon, CO 81620 |
| Ami K Doyle | Physical Therapy | Axis Sports Medicine LLC | 710 N Summit Blvd, Suite 103, Frisco, CO 80443 |
| Meredith H Mueller | Physical Therapy | Axis Sports Medicine LLC | 142 Beaver Creek Place, Unit 109, Avon, CO 81620 |
| Jennifer Rose Hutchings | Physical Therapy | Axis Sports Medicine LLC | 710 N Summit Blvd, Suite 103, Frisco, CO 80443 |
| Street Address |
142 BEAVER CREEK PLACE UNIT 109 |
| City | AVON |
| State | CO |
| Zip | 81620 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shannon M Irish | Physical Therapy | Axis Sports Medicine LLC | 142 Beaver Creek Place, Unit 109, Avon, CO 81620 |
| Sean P Juarez | Physical Therapy | Axis Sports Medicine LLC | 142 Beaver Creek Place, Unit 109, Avon, CO 81620 |
| Gentian Nuzzo | Physical Therapy | Axis Sports Medicine LLC | 142 Beaver Creek Place, Unit 109, Avon, CO 81620 |
| Meredith H Mueller | Physical Therapy | Axis Sports Medicine LLC | 142 Beaver Creek Place, Unit 109, Avon, CO 81620 |
| Alison Cofer Rybak | Physical Therapy | Axis Sports Medicine LLC | 142 Beaver Creek Place, Unit 109, Avon, CO 81620 |
| Robyn K Ritsch | Physical Therapy | Axis Sports Medicine LLC | 142 Beaver Creek Place, Unit 109, Avon, CO 81620 |
| Christine M Rost | Physical Therapy | Axis Sports Medicine LLC | 142 Beaver Creek Place, Unit 109, Avon, CO 81620 |
| Jennifer Lynn Sewall | Physical Therapy | Axis Sports Medicine LLC | 142 Beaver Creek Place, Unit 109, Avon, CO 81620 |
| Kathleen S Shaw | Physical Therapy | Axis Sports Medicine LLC | 142 Beaver Creek Place, Unit 109, Avon, CO 81620 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dana E Walenta | Nurse Practitioner | Vvmc Diversified Services | 220 Chapel Place Unit D, 102 Vail Health Clinic, Avon, CO 81620 |
| Daniel M Chesney | Chiropractic | 41191 Us Hwy 6 and 24, Avon, CO 81620 | |
| Bruce L Wignall | Chiropractic | 40780 Hwy 6 and 24, Avon, CO 81620 | |
| Stephen P. Laird | Gastroenterology | 50 Buck Creek Rd, Suite 200, Avon, CO 81620 | |
| Karie Burns | Nurse Practitioner | Vvmc Diversified Services | 220 Chapel Place Unit D, 102 Vail Health Clinic, Avon, CO 81620 |
| Keith P Samuels | Obstetrics/gynecology | Colorado Mountain Medical, PC | 50 Buck Creek Rd, Suite 200, Avon, CO 81620 |
| Jennifer L Pate | Physician Assistant | Colorado Mountain Medical, PC | 50 Buck Creek Rd, Suite 200, Avon, CO 81620 |
| Gale V Santa Maria | Obstetrics/gynecology | Colorado Mountain Medical, PC | 50 Buck Creek Rd, Suite 200, Avon, CO 81620 |
| Aaron M Loyd | Dermatology | Colorado Mountain Medical, PC | 50 Buck Creek Rd, Suite 200, Avon, CO 81620 |
| Ronald C Strahan | Otolaryngology | Colorado Mountain Medical, PC | 50 Buck Creek Rd, Suite 200, Avon, CO 81620 |
| Find all physicians in zip 81620 | |||
| City | AVON |
| Zip Code | 81620 |
| Specialty | PHYSICAL THERAPY |
| City + Specialty | AVON + PHYSICAL THERAPY |
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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.