| Lori Wertheimer, MD | |
| 
					192 Front St, Monument, CO 80132-6738  | |
| (719) 488-6998 | |
| (719) 488-8270 | 
| Full Name | Lori Wertheimer | 
|---|---|
| Gender | Female | 
| Speciality | Pediatrics | 
| Location | 192 Front St, Monument, Colorado | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1972543965 | NPI | - | NPPES | 
| 01310671 | Medicaid | CO | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | 31067 (Colorado) | Primary | 
| Entity Name | Poudre Valley Medical Group Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1225356868 PECOS PAC ID: 9638208549 Enrollment ID: O20100602000122  | 
| Entity Name | Optumcare Colorado Medical Group Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1407252828 PECOS PAC ID: 2769706431 Enrollment ID: O20150129000413  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Lori Wertheimer, MD 192 Front St, Monument, CO 80132-6738 Ph: (719) 488-6998  | Lori Wertheimer, MD 192 Front St, Monument, CO 80132-6738 Ph: (719) 488-6998  | 
Kirsten Ruth Martinson Nelson, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 17580 Colonial Park Dr, Monument, CO 80132 Phone: 719-487-0617  | |
Laura Dobbs Carson, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 17230 Jackson Creek Pkwy Monument Pediatrics, Suite #260, Monument, CO 80132 Phone: 719-488-6998 Fax: 719-488-8270  | |
Dr. Michael Halenkamp, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: Po Box 544, Monument, CO 80132 Phone: 719-522-1134 Fax: 719-268-2819  | |
Dr. Kathleen S Foote, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 15909 Jackson Creek Pkwy, Monument, CO 80132 Phone: 719-488-6998  | |
Dr. Diana Michaela Tapay, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 15909 Jackson Creek Pkwy, Monument, CO 80132 Phone: 719-488-6998  |