| Ncmc Specialty Clinic | |
|
1801 16th St Greeley CO 80631-5154 | |
| (970) 378-4475 | |
| Not Available |
| Full Name | Ncmc Specialty Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1801 16th St, Greeley, Colorado |
| Authorized Official Name and Position | Dennis Laraway (CFO) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ncmc Specialty Clinic 2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 Ph: () - | Ncmc Specialty Clinic 1801 16th St Greeley CO 80631-5154 Ph: (970) 378-4475 |
| NPI Number | 1023046620 |
|---|---|
| Provider Enumeration Date | 06/30/2006 |
| Last Update Date | 12/22/2021 |
| Medicare PECOS PAC ID | 8224027008 |
|---|---|
| Medicare Enrollment ID | O20040507000484 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023046620 | NPI | - | NPPES |
| 93588321 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Tamra M Meurer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316928542 PECOS PAC ID: 0941198238 Enrollment ID: I20070305000272 |
| Provider Name | Michael A Harkabus |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255304192 PECOS PAC ID: 8426064890 Enrollment ID: I20100114000478 |
| Provider Name | Robert P Vickerman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023085511 PECOS PAC ID: 1850364795 Enrollment ID: I20100126000675 |
| Provider Name | Cara Bruntz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194089425 PECOS PAC ID: 4385800218 Enrollment ID: I20120723000236 |
| Provider Name | Jaime L Cazer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639541550 PECOS PAC ID: 4587965694 Enrollment ID: I20151215000893 |
| Provider Name | Ronald W Quenzer |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1891755815 PECOS PAC ID: 1153316450 Enrollment ID: I20160708000489 |
| Provider Name | Travis C Polk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306355409 PECOS PAC ID: 4284979659 Enrollment ID: I20181213001854 |
| Provider Name | Jessica Lynn Fritz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073070199 PECOS PAC ID: 8022350198 Enrollment ID: I20190422001908 |
| Provider Name | Christopher Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750891834 PECOS PAC ID: 3173899622 Enrollment ID: I20191105001790 |
| Provider Name | Eric Luehr |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730381104 PECOS PAC ID: 3072782010 Enrollment ID: I20201204000396 |
| Provider Name | Wing Hei Hui |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477246593 PECOS PAC ID: 8224491535 Enrollment ID: I20230901002186 |
| Provider Name | Jessika Hinz |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1316171127 PECOS PAC ID: 1254556038 Enrollment ID: I20240223002426 |
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