IDEAL FAMILY MEDICINE, LTD (NPI# 1255865713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255865713 |
| Entity Type | Organization |
| Organization Name | IDEAL FAMILY MEDICINE, LTD |
| Practice Address |
2016 S Pueblo Blvd Pueblo CO 81005-2546 |
| Practice Telephone | 7195821489 |
| Practice Fax Number | 7199602290 |
| Mailing Fax Number | 7199602290 |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2017-04-11 |
| Authorized Official Name | JADE BRYANT (OWNER) |
| Authorized Official Telephone | 7192146491 |
| Authorized Official Credential | FNP-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0992962 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 1154861995 | 05 |
| Street Address |
2016 S PUEBLO BLVD |
| City | PUEBLO |
| State | CO |
| Zip Code | 81005-2546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225595630 | Kimberly Warfield | Specialist | 5825 W Hwy 78, Pueblo, CA 81005 | 2019-02-22 |
| 1417461823 | Yah Vision | Optometrist | 2568 Taylor Ln, Pueblo, CO 81005 | 2017-11-21 |
| 1245758168 | Jenny C Alas | Dentist | 2603 Vinewood Lane, Pueblo, CO 81005 | 2017-08-30 |
| 1801342472 | Cynthia Watson | Counselor | 2429 S. Prairie Avenue, Pueblo, CO 81005 | 2016-09-01 |
| 1598033664 | Kyle Andrew Bonds | Pharmacist | 2900 W. Northern Ave., Pueblo, CO 81005 | 2011-12-05 |
| 1346406196 | Samantha Coleman | Counselor | 2429 S Prairie Ave, Pueblo, CO 81005 | 2008-07-31 |
| 1184890915 | Hg Stringert Dds, Ms, PC | Dentist | 3955 Sandlewood Lane, Pueblo, CO 81005 | 2008-05-01 |
| 1992902423 | David Russell Baer | Dentist | 2041 Pepper Lane, Ste A, Pueblo, CO 81005 | 2007-06-28 |
| 1659443695 | Thomas Wesley Ready | Dentist | 643 So Pueblo Blvd, Pueblo, CO 81005 | 2006-11-14 |
| 1700969029 | Bradley Michael Almond | Dentist | 1221 S Pueblo Blvd, Pueblo, CO 81005 | 2006-10-23 |
| Find all providers in zip 81005 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708872 | Carla E Paredes Diaz | Nurse Practitioner | 2215 South Dr, Pueblo, CO 81008-1755 | 2020-10-21 |
| 1902435506 | Brandi Lanae Trujillo | Nurse Practitioner | 3107 E Spaulding Ave Unit 202, Pueblo, CO 81008-5219 | 2020-04-06 |
| 1346883097 | Parkview Ancillary Services | Nurse Practitioner | 1600 N Grand Ave Ste 210, Pueblo, CO 81003-2749 | 2019-10-25 |
| 1326535618 | Amanda Michelle Meade | Nurse Practitioner | 201 Lamkin St Apt 101, Pueblo, CO 81003-3558 | 2018-04-23 |
| 1316456981 | Amy R Leibli | Nurse Practitioner | 1080 Chinook Lane, Pueblo, CO 81001 | 2017-09-26 |
| 1154861995 | Jade Bryant | Nurse Practitioner | 1910 Lake Ave, Pueblo, CO 81004-3322 | 2017-02-27 |
| 1558811950 | Jane Graham | Nurse Practitioner | 1225 N Grand Ave, Pueblo, CO 81003-2845 | 2016-10-10 |
| 1124397559 | Michelle Leann Hartke | Nurse Practitioner | 1619 N Greenwood St Ste 208, Pueblo, CO 81003-2656 | 2011-12-14 |
| 1609008796 | Laura Ann Mcmahon | Nurse Practitioner | 4020 Jerry Murphy Rd/, Pueblo, CO 81001 | 2009-08-21 |
| 1851421796 | Kimberly A Crapeau | Nurse Practitioner | 2037 Jerry Murphy Rd Ste 200, Pueblo, CO 81001-1206 | 2007-03-07 |
| 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.