STEVEN PONICSAN JR. (NPI# 1699149120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699149120 |
| Entity Type | Individual |
| Full Name | STEVEN PONICSAN JR. |
| Credential | PA-C |
| Practice Address |
2930 11th Ave Evans CO 80620-1011 |
| Practice Telephone | 9703504606 |
| Practice Fax Number | 9703504645 |
| Mailing Telephone | 9703504606 |
| Mailing Fax Number | 9703504645 |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2015-11-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2930 11TH AVE |
| City | EVANS |
| State | CO |
| Zip Code | 80620-1011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164424354 | Leonard Alexander Lowe Jr. | Emergency Medicine | 2930 11th Ave, Evans, CO 80620-1011 | 2005-06-01 |
| 1386250843 | North Range Behavioral Health | Clinic/Center | 2930 11th Ave, Evans, CO 80620-1011 | 2020-09-21 |
| 1639780760 | Cassandra Bigley | Nurse Practitioner | 2930 11th Ave, Evans, CO 80620-1011 | 2020-08-12 |
| 1558993170 | Kelly Dineen Scott-kitzman | Nurse Practitioner | 2930 11th Ave, Evans, CO 80620-1011 | 2020-02-11 |
| 1851930663 | Sunrise Community Health | Clinic/Center | 2930 11th Ave, Evans, CO 80620-1011 | 2019-12-26 |
| 1942843743 | Emily E Wright | Physician Assistant | 2930 11th Ave, Evans, CO 80620-1011 | 2019-10-24 |
| 1053953232 | Hannah Constantin | Physician Assistant | 2930 11th Ave, Evans, CO 80620-1011 | 2019-10-09 |
| 1134695745 | Sarah Elizabeth Curzon | Physician Assistant | 2930 11th Ave, Evans, CO 80620-1011 | 2018-10-22 |
| 1881160638 | Krista Gail Jones | Physician Assistant | 2930 11th Ave, Evans, CO 80620-1011 | 2018-10-19 |
| 1376026336 | Amy Renee Brodeur | Nurse Practitioner | 2930 11th Ave, Evans, CO 80620-1011 | 2018-09-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932734605 | Focus Point Consulting LLC | Optometrist | Sams Club Optical, 3247 23rd Ave, Evans, CO 80620 | 2020-03-03 |
| 1992040786 | Homefront Health and Occupational Medicine LLC | Preventive Medicine | 1705 32nd St., Evans, CO 80620 | 2012-12-05 |
| 1295980233 | Joshua Woodland | Optometrist | 3247 23rd Ave., (inside Sams Club), Evans, CO 80620 | 2008-11-18 |
| 1619125903 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 3247 23rd Avenue, Evans, CO 80620 | 2008-08-29 |
| 1699300020 | Focus Point Consulting LLC | Optometrist | Sams Club Optical, 3247 23rd St, Evans, CO 80620 | 2020-03-05 |
| 1316430812 | Niki Avery Pediatric Pt LLC | Physical Therapist | 1050 37th St, Evans, CO 80620 | 2018-06-08 |
| 1013548866 | Envision Creative Support for People With Developmental Disabilities | Respite Care | 1050 37th Street, Evans, CO 80620-0069 | 2020-01-30 |
| 1760922827 | Shanea Barickman | Home Health Aide | 3222 11th Ave, 313, Evans, CO 80620-1545 | 2017-03-08 |
| 1013429695 | Malama Ohana LLC | Home Health | 3222 11th Ave Apt 313, Evans, CO 80620-1546 | 2017-11-03 |
| 1154578961 | Sams West Inc | Durable Medical Equipment & Medical Supplies | 3247 23rd Ave, Evans, CO 80620-1733 | 2008-08-22 |
| Find all providers in zip 80620 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518235217 | Kristin Jane House | Physician Assistant | 4446 Washington Rd, Ste # 7, Evans, GA 30809-6360 | 2011-12-08 |
| 1295985125 | Lauren Ourt Wieme | Physician Assistant | 465 N. Belair Rd, Suite 1b, Evans, GA 30809-3189 | 2008-09-29 |
| 1598830994 | Jennifer Miller Capito | Physician Assistant | 4244 Washington Road, Evans, GA 30809 | 2006-11-21 |
| 1427162270 | Jennifer Rochelle Mccarren | Physician Assistant | 1002 Williamsburg Way, Evans, GA 30809 | 2006-08-18 |
| 1790382711 | Mary-kathryn Christine Wilkins | Physician Assistant | 4350 Towne Centre Dr Ste 1400, Evans, GA 30809-3332 | 2020-10-02 |
| 1942843743 | Emily E Wright | Physician Assistant | 2930 11th Ave, Evans, CO 80620-1011 | 2019-10-24 |
| 1053953232 | Hannah Constantin | Physician Assistant | 2930 11th Ave, Evans, CO 80620-1011 | 2019-10-09 |
| 1134695745 | Sarah Elizabeth Curzon | Physician Assistant | 2930 11th Ave, Evans, CO 80620-1011 | 2018-10-22 |
| 1881160638 | Krista Gail Jones | Physician Assistant | 2930 11th Ave, Evans, CO 80620-1011 | 2018-10-19 |
| 1578038337 | Byron Tyrell Mathis | Physician Assistant | 4720 Washington Rd, Evans, GA 30809-5875 | 2018-10-09 |
| Find all providers in EVANS | ||||
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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.