DR. GEORGE R KIRACOFE (NPI# 1033137443) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033137443 |
| Entity Type | Individual |
| Full Name | DR. GEORGE R KIRACOFE |
| Credential | M.D. |
| Practice Address |
80 B Veterans Blvd I-40, Exit 102 Acoma NM 87034 |
| Mailing Address |
Po Box 130 San Fidel NM 87049-0130 |
| Practice Telephone | 5055525300 |
| Practice Fax Number | 5055525828 |
| Mailing Telephone | 5055525300 |
| Mailing Fax Number | 5055525828 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2015-05-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 22645 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | H3451 | 05 |
| Street Address |
80 B VETERANS BLVD I-40, EXIT 102 |
| City | ACOMA |
| State | NM |
| Zip Code | 87034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619970779 | James H Urbina | Internal Medicine | 80 B Veterans Blvd, I-40, Exit 102, Acoma, NM 87034 | 2005-05-23 |
| 1528604303 | Lisa Spero | Nurse Practitioner | 80 B Veterans Blvd, Acoma, NM 87034 | 2019-11-27 |
| 1689029860 | Muna S Sheikh | Internal Medicine | 80 B Veterans Blvd, Acoma, NM 87034 | 2016-04-26 |
| 1639523855 | Roberto Carlos Montes | Psychologist | 80 B Veterans Blvd, Acoma, NM 87034 | 2016-04-14 |
| 1972961068 | Aline Bayard | Nurse Practitioner | 80 B Veterans Blvd, Acoma, NM 87034 | 2016-02-03 |
| 1093188724 | Janet E Dominguez | Nurse Practitioner | 80 B Veterans Blvd, Acoma, NM 87034 | 2015-11-03 |
| 1124491949 | Patricia A Monroe | Nurse Practitioner | 80 B Veterans Blvd, Acoma, NM 87034 | 2015-11-02 |
| 1033594122 | Hlengiwe Lindani Sibanda | Nurse Practitioner | 80 B Veterans Blvd, Acoma, NM 87034-0536 | 2015-07-30 |
| 1851774392 | Caleb Vanderveen | Family Medicine | 80 B Veterans Blvd, Acoma, NM 87034 | 2015-07-01 |
| 1669721122 | Shawn P Giorgianni | Emergency Medical Technician, Paramedic | 80 B Veterans Blvd, Acl-ihs, Acoma, NM 87034 | 2012-08-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114535192 | Troy Stephen Weeldreyer | Social Worker | 45 Pinsbaari Dr, Acoma, NM 87034 | 2020-07-16 |
| 1306486857 | Mallery Chino | Case Manager/Care Coordinator | 47 Pinsbarri Drive, Acoma, NM 87034 | 2020-01-13 |
| 1700340841 | Thomas Simon Vallo | Case Manager/Care Coordinator | 45 Pinbaari Drive, Acoma, NM 87034 | 2019-01-23 |
| 1649777053 | Amanda Jean Garcia | Counselor | 99b Sunrise Rd, Pueblo of Acoma, NM 87034 | 2018-04-11 |
| 1356850754 | Korey B Still | Dentist | 80 B Veterans Blvd., Acoma, NM 87034 | 2017-09-28 |
| 1508395278 | Shelby Bobelu | Social Worker | 45 Pinsbarri Dr., Acoma, NM 87034 | 2017-06-07 |
| 1558817270 | Amanda Lucario | Technician, Other | 1253 Haaku Road, Acoma, NM 87034 | 2016-09-01 |
| 1073961355 | Rhayna Dannielle Walizer | Social Worker | 45 Pinsbarri Dr, Acoma, NM 87034 | 2016-05-27 |
| 1417305715 | Everett Chavez | Counselor | 45 Pinsbaari, Acoma, NM 87034 | 2016-05-26 |
| 1952758047 | Lonnie Lewis | Counselor | 33 Pinsbaari Drive, Acoma, NM 87034 | 2016-05-18 |
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| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851774392 | Caleb Vanderveen | Family Medicine | 80 B Veterans Blvd, Acoma, NM 87034 | 2015-07-01 |
| 1679893374 | Mariana Mejia Botero | Family Medicine | 80 B Veterans Blvd, Acoma, NM 87034 | 2010-06-03 |
| 1881922748 | Casey F Onik | Family Medicine | 80 B Veterans Blvd, Acoma, NM 87034 | 2009-12-03 |
| 1467657841 | Brian F Hanley | Family Medicine | 80 B Veterans Blvd, Acoma, NM 87034 | 2007-06-18 |
| 1821077298 | Stephen K Williams | Family Medicine | 80 B Veterans Blvd, Acoma, NM 87034 | 2006-01-12 |
| 1750374690 | Nabil M Habib | Family Medicine | 80 B Veterans Blvd, I-40, Exit 102, Acoma, NM 87034 | 2005-08-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.