| Colorado Plains Physician Practices Llc | |
|
1006 Lake St Fort Morgan CO 80701-3031 | |
| (970) 867-7900 | |
| (970) 867-1950 |
| Full Name | Colorado Plains Physician Practices Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1006 Lake St, Fort Morgan, Colorado |
| Authorized Official Name and Position | Monica Bowman (PRESIDENT) |
| Authorized Official Contact | 6159207000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colorado Plains Physician Practices Llc 330 Seven Springs Way Brentwood TN 37027-5098 Ph: (615) 920-7000 | Colorado Plains Physician Practices Llc 1006 Lake St Fort Morgan CO 80701-3031 Ph: (970) 867-7900 |
| NPI Number | 1821042409 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 02/09/2023 |
| Medicare PECOS PAC ID | 4082628706 |
|---|---|
| Medicare Enrollment ID | O20060202000338 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821042409 | NPI | - | NPPES |
| 34427732 | Medicaid | CO | |
| DD5267 | Other | CO | RAILROAD MEDICARE |
| CO677558 | Other | CO | BCBS OF COLORADO |
| Provider Name | Edward M Lopez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376512665 PECOS PAC ID: 3971492968 Enrollment ID: I20040315001446 |
| Provider Name | Lynn R Dilley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710954748 PECOS PAC ID: 7810887486 Enrollment ID: I20040317001002 |
| Provider Name | Michelle L Soriano |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447233226 PECOS PAC ID: 1850352170 Enrollment ID: I20041020000917 |
| Provider Name | Johnny E Johnson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588692628 PECOS PAC ID: 9931109444 Enrollment ID: I20070118000373 |
| Provider Name | James B Smith |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295727840 PECOS PAC ID: 8921103540 Enrollment ID: I20070410000342 |
| Provider Name | Sara E Tisdale |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467668798 PECOS PAC ID: 3476641721 Enrollment ID: I20071120000237 |
| Provider Name | Donald G Kruglet |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932298270 PECOS PAC ID: 4486711132 Enrollment ID: I20100811001001 |
| Provider Name | Michelle R Nadon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417261017 PECOS PAC ID: 8426243536 Enrollment ID: I20101115001272 |
| Provider Name | Anne C Manchester |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750532552 PECOS PAC ID: 1850587767 Enrollment ID: I20101117001607 |
| Provider Name | Thomas L Manchester |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083889927 PECOS PAC ID: 1759577661 Enrollment ID: I20101117001620 |
| Provider Name | Isabelle M Audet |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1396732079 PECOS PAC ID: 0143128439 Enrollment ID: I20110325000114 |
| Provider Name | Elias O Ruiloba |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124014196 PECOS PAC ID: 0648241851 Enrollment ID: I20110822000365 |
| Provider Name | Olga Justyna Dobranowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184943763 PECOS PAC ID: 4688844251 Enrollment ID: I20110909002512 |
| Provider Name | Kenneth Keller |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1104976802 PECOS PAC ID: 1658354543 Enrollment ID: I20120723000754 |
| Provider Name | Lauren D Melancon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861740276 PECOS PAC ID: 9133379167 Enrollment ID: I20121026000646 |
| Provider Name | Laurie L Mahar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891706701 PECOS PAC ID: 7315082807 Enrollment ID: I20130726000319 |
| Provider Name | Anil R Aleti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518279488 PECOS PAC ID: 3870775109 Enrollment ID: I20130823000327 |
| Provider Name | Kaare Kolstad |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1922042373 PECOS PAC ID: 5092760884 Enrollment ID: I20140904000101 |
| Provider Name | Jacquelyn Glenn |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831272822 PECOS PAC ID: 8921087461 Enrollment ID: I20150318002275 |
| Provider Name | Amy M Prince |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972700193 PECOS PAC ID: 9032430624 Enrollment ID: I20150608002302 |
| Provider Name | Kathleen Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750756896 PECOS PAC ID: 1052613049 Enrollment ID: I20160107002454 |
| Provider Name | Anthony W Cooper |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457588428 PECOS PAC ID: 0749506046 Enrollment ID: I20160609001365 |
| Provider Name | Thomas E Kasper |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1386645000 PECOS PAC ID: 9638359607 Enrollment ID: I20160720000631 |
| Provider Name | Christine Black |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1013282169 PECOS PAC ID: 7416186598 Enrollment ID: I20160914001787 |
| Provider Name | Tiffany A Jorgensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548711393 PECOS PAC ID: 3577843796 Enrollment ID: I20161206000242 |
| Provider Name | Tawana N Nix |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649324294 PECOS PAC ID: 0749304152 Enrollment ID: I20170407001277 |
| Provider Name | Stephen Chandler Wills |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710390612 PECOS PAC ID: 8325362767 Enrollment ID: I20170824001090 |
| Provider Name | Nathan Charapata |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578982864 PECOS PAC ID: 7517265705 Enrollment ID: I20171218000626 |
| Provider Name | Irfan Qureshi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881853133 PECOS PAC ID: 5799006508 Enrollment ID: I20190213002742 |
| Provider Name | Christopher A Wright |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669748489 PECOS PAC ID: 6608169123 Enrollment ID: I20190416002541 |
| Provider Name | Amanda Lauren Hrycaj |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497212377 PECOS PAC ID: 7517200611 Enrollment ID: I20190513000870 |
| Provider Name | Christina Alison Pavelko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700236668 PECOS PAC ID: 4587932785 Enrollment ID: I20190801000131 |
| Provider Name | Jennifer L Romero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295378016 PECOS PAC ID: 8729410121 Enrollment ID: I20191122000613 |
| Provider Name | Robert Kistner |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063404572 PECOS PAC ID: 8921028424 Enrollment ID: I20191205001608 |
| Provider Name | Trevin John Cardon |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720584246 PECOS PAC ID: 4587928734 Enrollment ID: I20210629001868 |
| Provider Name | Matthew M Wood |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164955233 PECOS PAC ID: 0840619854 Enrollment ID: I20211116001936 |
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