WESTERN COLORADO TECHNICAL NEUROMONITORING, LLC (NPI# 1427380278) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427380278 |
| Entity Type | Organization |
| Organization Name | WESTERN COLORADO TECHNICAL NEUROMONITORING, LLC |
| Practice Address |
2580 Allen Adale Rd Fairbanks AK 99709-2580 |
| Mailing Address |
Po Box 413136 Salt Lake City UT 84141-3136 |
| Practice Telephone | 2255884845 |
| Practice Fax Number | 2256126561 |
| Mailing Telephone | 2255884845 |
| Mailing Fax Number | 2256126561 |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2016-11-01 |
| Authorized Official Name | JOHN LOPEZ (OWNER) |
| Authorized Official Telephone | 2255884845 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
Technologists, Technicians & Other Technical Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Western Colorado Technical Neuromonitoring, LLC | 2580 Allen Adale Road, Fairbanks, AK 99709 |
| Street Address |
2580 ALLEN ADALE RD |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99709-2580 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174855928 | Western Colorado Professional Neuromonitoring | Specialist | 2580 Allen Adale Rd, Fairbanks, AK 99709-2580 | 2010-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255946810 | Beacon Monitoring Professional Services | Technician, Other | 745 Staffordshire Rd, Fairbanks, AK 99709 | 2020-09-10 |
| 1235629544 | Fairbanks Healing Space | Health Educator | 3875 Geist Road, Suite E #136, Fairbanks, AK 99709 | 2018-05-11 |
| 1609395409 | Shawn K Goggins | Counselor | 1423 Peger Road, Fairbanks, AK 99709 | 2017-09-12 |
| 1710433347 | Jay Titus | Technician/Technologist | 2884 Marina Drive, Fairbanks, AK 99709 | 2016-09-01 |
| 1710391610 | Hannah Summerfelt | Dentist | 3539 Thomas St, Fairbanks, AK 99709 | 2014-06-18 |
| 1629407325 | Diane Louise Mitchell | Nurse Practitioner | 4650 Harvard Cir, Fairbanks, AK 99709 | 2013-11-04 |
| 1407147929 | Christina Martz | Counselor | 1270 Summet Drive, Fairbanks, AK 99709 | 2011-05-02 |
| 1255652285 | Surgery Center of Fairbanks LLC | Clinic/Center | 2310 Peger Road, Fairbanks, AK 99709 | 2010-06-14 |
| 1962661835 | John Leo Hughes Jr Jr. | Dentist | 3437 Airport Way, Suite 205, Fairbanks, AL 99709 | 2008-06-05 |
| 1508042417 | Katherine E Johnson, Md PC | Ophthalmology | 2485 Chief William Drive, Suite 100, Fairbanks, AK 99709 | 2008-01-10 |
| Find all providers in zip 99709 | ||||
| Taxonomy Code | 246ZE0600X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Electroneurodiagnostic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457873440 | Tamara Wilson | Specialist/Technologist, Other | 2310 Peger Rd Ste 106, Fairbanks, AK 99709-5305 | 2017-07-11 |
| 1649623968 | Kyle Bryant Smith | Specialist/Technologist, Other | 825 9th Ave Apt 2, Fairbanks, AK 99701-4408 | 2016-07-21 |
| 1639597727 | Brent Tyler | Specialist/Technologist, Other | 2733 Doreen Ct, Fairbanks, AK 99709-2424 | 2014-04-04 |
| 1639576242 | Beacon Monitoring | Specialist/Technologist, Other | 1650 Cowles St, Fairbanks, AK 99701-5907 | 2014-11-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427665280 | Alaska Monitoring Associates, Inc. | Specialist/Technologist, Other | 11641 Woodbourne Dr, Anchorage, AK 99516-1279 | 2020-09-25 |
| 1295374510 | Alaska Professional Neuromonitoring, LLC | Specialist/Technologist, Other | 10672 Kenai Spur Highway, Suite 112 -132, Kenai, AK 99611-9961 | 2020-01-03 |
| 1376976092 | Rebecca Jane Webster | Specialist/Technologist, Other | 3732 Deborah Ln, Anchorage, AK 99504-4603 | 2013-08-16 |
| 1437400132 | Mitchel Paul Lepschat | Specialist/Technologist, Other | 7441 Timberwolf Cir, Anchorage, AK 99507-4812 | 2012-09-21 |
| 1841839164 | Alaska Technical Neuromonitoring. LLC | Specialist/Technologist, Other | 10672 Kenai Spur Highway, Suite 112-132, Kenai, AK 99611-9961 | 2020-01-03 |
Please comment or provide details below to improve the information on WESTERN COLORADO TECHNICAL NEUROMONITORING, LLC.
| 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.