Derrick Roth Fansler (NPI# 1760626519, PAC ID# 9537398920) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CARDIAC ELECTROPHYSIOLOGY.
| Nation Provider ID (NPI) | 1760626519 |
| PAC ID by PECOS | 9537398920 |
| Professional Enrollment ID | I20140930000335 |
| Full Name | Derrick Roth Fansler |
| Organization Legal Name | COLORADO CARDIAC ALLIANCE, LLC |
| Address |
2222 N Nevada Ave Suite 4007 Colorado Springs CO 80907-6863 |
| Phone Number | 7196346671 |
| Gender | M |
| Medical School | NORTHWESTERN UNIVERSITY MEDICAL SCHOOL |
| Graduation Year | 2007 |
| Primary Specialty | CARDIAC ELECTROPHYSIOLOGY |
| Secondary Specialties | CARDIOVASCULAR DISEASE (CARDIOLOGY), INTERNAL MEDICINE |
| Group Practice PAC ID | 5193718021 |
| Number of Group Practice Members | 19 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 060031 | CENTURA HEALTH-PENROSE ST FRANCIS HEALTH SERVICES |
| 061322 | HEART OF THE ROCKIES REGIONAL MEDICAL CENTER |
| 060015 | CENTURA HEALTH-ST ANTHONY HOSPITAL |
| 061344 | |
| 060022 | UCH-MEMORIAL HEALTH SYSTEM |
| Address | Phone | Organization |
|---|---|---|
| 2222 N Nevada Ave, Suite 4007, Colorado Springs, CO 80907-6863 | 7196346671 | COLORADO CARDIAC ALLIANCE, LLC |
| 2222 N Nevada Ave, Suite 4007, Colorado Springs, CO 80907-6863 | 7197768500 | CATHOLIC HEALTH INITIATIVES COLORADO |
| Organization Legal Name | COLORADO CARDIAC ALLIANCE, LLC |
| Physicians | 18 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Chad Clark Schooley | Interventional Cardiology | Colorado Cardiac Alliance, LLC | 2222 N Nevada Ave, Suite 4007, Colorado Springs, CO 80907-6863 |
| Preetham Reddy | Cardiovascular Disease (cardiology) | Colorado Cardiac Alliance, LLC | 2222 N Nevada Ave, Suite 4007, Colorado Springs, CO 80907-6863 |
| Deborah Ann Jalowiec | Cardiovascular Disease (cardiology) | Colorado Cardiac Alliance, LLC | 2222 N Nevada Ave, Suite 4007, Colorado Springs, CO 80907-6863 |
| Kumar Sanam | Cardiovascular Disease (cardiology) | Colorado Cardiac Alliance, LLC | 2222 N Nevada Ave, Suite 4007, Colorado Springs, CO 80907-6863 |
| Kimberly Dulaney | Cardiovascular Disease (cardiology) | Colorado Cardiac Alliance, LLC | 2222 N Nevada Ave, Suite 4007, Colorado Springs, CO 80907-6863 |
| Christopher R Cole | Cardiovascular Disease (cardiology) | Colorado Cardiac Alliance, LLC | 2222 N Nevada Ave, Suite 4007, Colorado Springs, CO 80907-6863 |
| Arash Aghel | Interventional Cardiology | Colorado Cardiac Alliance, LLC | 2222 N Nevada Ave, Suite 4007, Colorado Springs, CO 80907-6863 |
| Clinton Michael Malone | Interventional Cardiology | Colorado Cardiac Alliance, LLC | 2222 N Nevada Ave, Suite 4007, Colorado Springs, CO 80907-6863 |
| William L Barry | Cardiovascular Disease (cardiology) | Colorado Cardiac Alliance, LLC | 2222 N Nevada Ave, Suite 4007, Colorado Springs, CO 80907-6863 |
| Chris Yongdok Kim | Cardiovascular Disease (cardiology) | Colorado Cardiac Alliance, LLC | 2222 N Nevada Ave, Suite 4007, Colorado Springs, CO 80907-6863 |
| Street Address |
2222 N NEVADA AVE SUITE 4007 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip | 80907-6863 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Chad Clark Schooley | Interventional Cardiology | Colorado Cardiac Alliance, LLC | 2222 N Nevada Ave, Suite 4007, Colorado Springs, CO 80907-6863 |
| Sara Elizabeth Roper | Physician Assistant | Colorado Springs Surgical Associates | 2222 N Nevada Ave, Suite 5017, Colorado Springs, CO 80907-6831 |
| Preetham Reddy | Cardiovascular Disease (cardiology) | Colorado Cardiac Alliance, LLC | 2222 N Nevada Ave, Suite 4007, Colorado Springs, CO 80907-6863 |
| Sarah Kate Roark | Nurse Practitioner | Colorado Springs Pulmonary Consultants PC | 2222 N Nevada Ave, Suite 4004, Colorado Springs, CO 80907-6832 |
| William Clark Chambers Jr. | General Surgery | Catholic Health Initiatives Colorado | 2222 N Nevada Ave, 5010 Chpg Spr Ss (southern Co Vascular Surgery), Colorado Springs, CO 80907-6865 |
| Benjamin Arthur Delano | General Surgery | Colorado Springs Surgical Associates | 2222 N Nevada Ave, Suite 5017, Colorado Springs, CO 80907-6831 |
| Matthew Burkholder | Physician Assistant | Colorado Springs Surgical Associates | 2222 N Nevada Ave, Suite 5017, Colorado Springs, CO 80907-6831 |
| Claudia Hildegard Martin | Neurosurgery | Catholic Health Initiatives Colorado | 2222 N Nevada Ave, Suite 5001, Colorado Springs, CO 80907-6865 |
| Ryan S Okal | Pathology | Mountain States Pathology PC | 2222 N Nevada Ave, Colorado Springs, CO 80907-6819 |
| Matthew J Schippers | Hospitalist | Catholic Health Initiatives Colorado | 2222 N Nevada Ave, Chpg Hospitalists Penrose St Francis, Colorado Springs, CO 80907-6819 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Frank D Polanco | Pain Management | 1495 Garden of The Gods Rd, Suite 102, Colorado Springs, CO 80907-3429 | |
| Laura Marie Rodholm | Physical Therapy | 1495 Garden of The Gods Rd, Suite 102, Colorado Springs, CO 80907-3429 | |
| Elvin L White | Chiropractic | 1045 Garden of The Gods Rd A, Colorado Springs, CO 80907-3436 | |
| Kelsey A Kuehn | Physical Therapy | Ascend Physical Therapy PC | 753 Garden of The Gods Rd, Colorado Springs, CO 80907-3505 |
| Karli Rikli | Physical Therapy | Orthopedic Rehabilitation Associates PC | 602 Elkton Dr, Colorado Springs, CO 80907-3514 |
| Lewis Baumann | Physical Therapy | Orthopedic Rehabilitation Associates PC | 602 Elkton Dr, Colorado Springs, CO 80907-3514 |
| Daniel P Fogarty | Physical Therapy | Orthopedic Rehabilitation Associates PC | 602 Elkton Dr, Colorado Springs, CO 80907-3514 |
| Raymond A Martinez Ii | Physical Therapy | Orthopedic Rehabilitation Associates PC | 602 Elkton Dr, Colorado Springs, CO 80907-3514 |
| Ashleigh Sloane Hayden | Speech Language Pathologist | Orthopedic Rehabilitation Associates PC | 602 Elkton Dr, Colorado Springs, CO 80907-3514 |
| Shirley D Robbins | Psychologist, Clinical | 720 Elkton Dr, Suite 107, Colorado Springs, CO 80907-3516 | |
| Find all physicians in zip 80907 | |||
| City | COLORADO SPRINGS |
| Zip Code | 80907 |
| Specialty | CARDIAC ELECTROPHYSIOLOGY |
| City + Specialty | COLORADO SPRINGS + CARDIAC ELECTROPHYSIOLOGY |
Please comment or provide details below to improve the information on Derrick Roth Fansler.
| 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.