SHAWN JETT NAKAMURA (NPI# 1063497246) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063497246 |
| Entity Type | Individual |
| Full Name | SHAWN JETT NAKAMURA |
| Credential | M.D. |
| Practice Address |
4112 Outlook Blvd Ste 37 Pueblo CO 81008-1667 |
| Mailing Address |
230 Bridle Trl Pueblo CO 81005-2906 |
| Practice Telephone | 7195626254 |
| Practice Fax Number | 7195626255 |
| Mailing Telephone | (719) 252-1064 |
| Enumeration Date | 2005-12-12 |
| Last Update Date | 2017-07-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 44158 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 28624777 | 05 | |
| MN | MEDICARE RAILROAD | P00031174 | 01 |
| Street Address |
4112 OUTLOOK BLVD STE 37 |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008-1667 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164023131 | Pueblo Radiological Group, P.C. | Radiology | 4112 Outlook Blvd Ste 37, Pueblo, CO 81008-1667 | 2020-11-05 |
| 1073926036 | Randi Nichole Lininger | Specialist/Technologist | 4112 Outlook Blvd Ste 37, Pueblo, CO 81008-1667 | 2014-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164058913 | Healthone Clinic Services - Oncology Hematology LLC | Internal Medicine | 3678 Parker Blvd, Pueblo, CO 81008 | 2020-03-12 |
| 1073026423 | Carmel Community Living Corporation | Respite Care | 2003 Northmoor Terrace, Suite 100, Pueblo, CO 81008 | 2017-11-08 |
| 1568987121 | Hannah Vivian Roadruck | Pharmacist | 4200 Dillon Dr., Pueblo, CO 81008 | 2017-08-04 |
| 1184170425 | Brett Burana | Dentist | 729 Us-50, Pueblo, CO 81008 | 2016-08-28 |
| 1760832885 | Irby Dental Cottage | Dental Hygienist | 2099 West St # 50, Suite 180, Pueblo, CO 81008 | 2016-06-20 |
| 1649624362 | Curley Peak Dentistry Pllc | Dentist | 1640 W Fortino Blvd, Pueblo, CO 81008 | 2016-04-19 |
| 1336507847 | Kyle Tipton | Nurse Anesthetist, Certified Registered | 4741 Eagleridge Circle, 206, Pueblo, CO 81008 | 2016-01-29 |
| 1407211931 | Center At Park West, LLC | Skilled Nursing Facility | 3727 Parker Blvd., Pueblo, CO 81008 | 2015-12-29 |
| 1417327461 | Nicole Betts | Registered Nurse | 1310 Fortino Blvd Ste D, Pueblo, CO 81008 | 2015-10-02 |
| 1437578028 | Pueblo Modern Dentistry and Orthodontics, LLP | Dentist | 727 Us Hwy 50 West, Pueblo, CO 81008 | 2014-04-10 |
| Find all providers in zip 81008 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497780498 | Pueblo Orthopedic Professional Corporation | Orthopaedic Surgery | 1008 Minnequa Ave # 1501, Pueblo, CO 81004-3733 | 2006-07-11 |
| 1952334179 | Twee Thi Do | Orthopaedic Surgery | 3676 Parker Blvd Ste 110, Pueblo, CO 81008-2213 | 2006-07-09 |
| 1174593081 | Lance R. Farnworth | Orthopaedic Surgery | 1919 W Us Highway 50, Pueblo, CO 81008-1618 | 2006-01-24 |
| 1114216421 | Lucas Raymond King | Orthopaedic Surgery | 3676 Parker Blvd., Ste 310, Pueblo, CO 81008-2215 | 2011-04-07 |
| 1124274949 | Roger W. Davis, Md, LLC | Orthopaedic Surgery | 511 W 29th St, Suite B, Pueblo, CO 81008-1128 | 2008-08-12 |
| 1124220595 | Alex Anthony Romero | Orthopaedic Surgery | 4112 Outlook Blvd, Suite 37, Pueblo, CO 81008-1667 | 2007-06-05 |
| 1568534642 | Pueblo Bone and Joint Clinic LLC | Orthopaedic Surgery | 1919 W Us Highway 50, Pueblo, CO 81008-1618 | 2006-11-14 |
| 1285714402 | Mark Porter | Orthopaedic Surgery | 3530 E Spaulding Ave, Pueblo, CO 81008-2209 | 2006-10-16 |
| 1083624944 | Robert Thomas | Orthopaedic Surgery | 3530 E Spaulding Ave, Pueblo, CO 81008-2209 | 2006-08-09 |
| 1861409310 | Thomas A Hoffeld | Orthopaedic Surgery | 3530 E Spaulding Ave, Pueblo, CO 81008-2209 | 2006-08-01 |
| Find all providers in PUEBLO | ||||
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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.