JODELL C SAMS CRNFA, LLC (NPI# 1578129839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578129839 |
| Entity Type | Organization |
| Organization Name | JODELL C SAMS CRNFA, LLC |
| Practice Address |
2911 Country Club Dr Pueblo CO 81008-1202 |
| Practice Telephone | 7192402008 |
| Mailing Telephone | 7192402008 |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2019-05-13 |
| Authorized Official Name | JODELL C WARNER (CRNFA) |
| Authorized Official Telephone | 7192402008 |
| Authorized Official Credential | CRNFA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285290577 | Jodell C Sams Crnfa, LLC | Registered Nurse | 2911 Country Club Dr, Pueblo, CO 81008-1202 | 2019-05-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | JODELL C SAMS CRNFA, LLC | 1676 Camino De Los Ranchos, Pueblo, CO 81007 |
| Street Address |
2911 COUNTRY CLUB DR |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008-1202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104117464 | Jodell Carey Sams | Registered Nurse | 2911 Country Club Dr, Pueblo, CO 81008-1202 | 2011-04-21 |
| 1285290577 | Jodell C Sams Crnfa, LLC | Registered Nurse | 2911 Country Club Dr, Pueblo, CO 81008-1202 | 2019-05-13 |
| 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 | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245896778 | Professional Associates of Surgical Services Inc. | Physician Assistant | 3136 Bighorn Ct, Pueblo, CO 81005-4016 | 2019-05-09 |
| 1114397437 | Andrew Christopher Glass | Physician Assistant | 1600 North Grand Ave., Suite 508, Pueblo, CO 81003-2757 | 2015-09-29 |
| 1285889154 | Mark Neal Rice | Physician Assistant | 3676 Parker Blvd, Suite 110, Pueblo, CO 81008-2212 | 2008-11-19 |
| 1154529790 | David J. Widhalm | Physician Assistant | 1600 W 24th St, Pueblo, CO 81003-1411 | 2007-07-05 |
| 1750473526 | Franklin Peter Sloan Jr. | Physician Assistant | 3530 Spaulding Ave, Pueblo, CO 81008-2209 | 2006-09-29 |
| 1528039245 | Robert W. Simmons | Physician Assistant | 4112 Outlook Blvd, Suite 37, Pueblo, CO 81008-1667 | 2006-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033737366 | Wound Solutions Inc | Physician Assistant | 130 Old Laramie Trl Ste 100, Lafayette, CO 80026-7014 | 2020-07-13 |
| 1295396513 | Joseph D Timmermeyer | Physician Assistant | 324 Fossil Dr, Johnstown, CO 80534-7452 | 2019-06-26 |
| 1356805626 | Heather Free | Physician Assistant | 3653 N Josephine St, Denver, CO 80205-3545 | 2019-01-30 |
| 1255804910 | Jessie P Larson | Physician Assistant | 7847 Downing St, Denver, CO 80229-5961 | 2019-01-05 |
| 1710453543 | Lindsay Marie Bergman | Physician Assistant | 1140 Edwards Village II, B-105, Edwards, CO 81632 | 2018-10-19 |
| 1225533136 | Rafael Eduardo Castillo | Physician Assistant | 6200 Habitat Dr Apt 2052, Boulder, CO 80301-3235 | 2018-03-25 |
| 1972026276 | Sophia Jane Wagner | Physician Assistant | 2643 Patterson Rd Ste 403, Grand Junction, CO 81506-1937 | 2017-07-19 |
| 1326588732 | Elise Nicole Van Etten | Physician Assistant | 13123 E 16th Ave # 323, Anschutz Medical Campus, Aurora, CO 80045-7106 | 2017-03-03 |
| 1336691914 | Patrick Craig Ford | Physician Assistant | 6500 29th St Ste 106, Greeley, CO 80634-8386 | 2016-10-28 |
| 1942751904 | 5280 Surgical Assisting Professional LLC | Physician Assistant | 10233 Bluffmont Dr, Lone Tree, CO 80124-5559 | 2016-10-14 |
| Find all providers with the same taxonomy | ||||
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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.