DR. KEVIN JAMES CUCCINELLI (NPI# 1770553794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770553794 |
| Entity Type | Individual |
| Full Name | DR. KEVIN JAMES CUCCINELLI |
| Credential | MD |
| Practice Address |
1001 E Johnson St Holyoke CO 80734-1854 |
| Practice Telephone | 9708542241 |
| Practice Fax Number | 9704584581 |
| Mailing Telephone | 9708542241 |
| Mailing Fax Number | 9704584581 |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2020-08-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | DR.0042299 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 39532721 | 05 | |
| CO | CO LICENSE NUMBER | DR.0042299 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 23500 Us Highway 160, Walsenburg, CO 810899524 | 7197385100 |
| Street Address |
1001 E JOHNSON ST |
| City | HOLYOKE |
| State | CO |
| Zip Code | 80734-1854 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972139012 | Healthone Clinic Services - Cardiovascular LLC | Internal Medicine | 1001 E Johnson St, Holyoke, CO 80734-1854 | 2020-03-20 |
| 1790315315 | Poudre Valley Medical Group, LLC | Internal Medicine | 1001 E Johnson St, Holyoke, CO 80734-1854 | 2020-01-23 |
| 1124689336 | Alexandra E Gada | Optometrist | 1001 E Johnson St, Holyoke, CO 80734-1854 | 2019-06-27 |
| 1790264745 | Arika Lanae Luedke | Dental Hygienist | 1001 E Johnson St, Holyoke, CO 80734-1854 | 2018-08-10 |
| 1235624990 | East Phillips County Hospital District | Dentist | 1001 E Johnson St, Holyoke, CO 80734-1854 | 2018-06-26 |
| 1063901460 | Derek Reed Doorn | Nurse Practitioner | 1001 E Johnson St, Holyoke, CO 80734-1854 | 2018-05-02 |
| 1356842652 | East Phillips County Hospital District | Ambulance | 1001 E Johnson St, Holyoke, CO 80734-1854 | 2018-02-22 |
| 1265971006 | East Phillips County Hospital District | Optometrist | 1001 E Johnson St, Holyoke, CO 80734-1854 | 2017-02-13 |
| 1962944801 | East Phillips County Hospital District | Nurse Anesthetist, Certified Registered | 1001 E Johnson St, Holyoke, CO 80734-1854 | 2016-11-09 |
| 1861940439 | East Phillips County Hospital District | Pharmacy | 1001 E Johnson St, Holyoke, CO 80734-1854 | 2016-09-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992053706 | Sandra Mendoza Rafols | Physical Therapy Assistant | 618 S. Interocean Ave., Holyoke, CO 80734 | 2012-08-28 |
| 1952574105 | Pamida Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 118 South Interocean Ave, Holyoke, CO 80734 | 2008-04-09 |
| 1891935797 | Centennial Mental Health Center | Community/Behavioral Health | 115 N Campbell Ave, Holyoke, CO 80734-1003 | 2009-03-05 |
| 1851810337 | Centennial Mental Health Center, Inc. | Clinic/Center | 115 N Campbell Ave, Holyoke, CO 80734-1003 | 2017-09-15 |
| 1093113938 | Sharon Murray | Social Worker | 115 N Campbell Ave, Holyoke, CO 80734-1003 | 2014-12-09 |
| 1629484795 | Dorothy Drake | Social Worker | 115 N Campbell Ave, Holyoke, CO 80734-1003 | 2014-07-09 |
| 1932538725 | Ronnie Bahler | Social Worker | 115 N Campbell Ave, Holyoke, CO 80734-1003 | 2013-11-02 |
| 1942565296 | Jose Leon | Counselor | 115 N Campbell Ave, Holyoke, CO 80734-1003 | 2012-07-11 |
| 1831328087 | Edward Barry Winckler | Counselor | 115 N Campbell Ave, Holyoke, CO 80734-1003 | 2009-07-09 |
| 1194077560 | J&j Pharms. LLC. | Pharmacy | 112 E Carnahan St, Holyoke, CO 80734-1007 | 2012-10-10 |
| Find all providers in zip 80734 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760793244 | Aaron Lindley Wilson | Family Medicine | 645 S Sheridan Ave, Holyoke, CO 80734-1233 | 2010-06-29 |
| 1790915569 | Thomas James Graziano | Family Medicine | 10 Hospital Dr Ste 104, Holyoke, MA 01040-6603 | 2009-07-15 |
| 1275649105 | Elizabeth J Noyes | Family Medicine | 10 Hospital Drive, Suite 305, Western Mass Physician Associates, Inc, Holyoke, MA 01040 | 2006-08-22 |
| 1245248715 | Holyoke Family Practice, PC | Family Medicine | 195 High St, Holyoke, MA 01040-6504 | 2006-08-03 |
| 1427065549 | Dennis J. Jelden | Family Medicine | 1001 E. Johnston Street, Holyoke, CO 80734-1854 | 2006-08-02 |
| 1356398689 | Thomas M Klepacki | Family Medicine | 1221 Main Street, Western Regional/medical Examiner, Holyoke, MA 01040 | 2006-05-30 |
| 1720556327 | Sarah Elizabeth Kells | Family Medicine | 306 Race St, Holyoke, MA 01040-5720 | 2018-11-13 |
| 1184178386 | Sound Physicians of Massachusetts, Inc | Family Medicine | 575 Beech St, Holyoke, MA 01040-2223 | 2016-08-05 |
| 1861806929 | Daniela Monique De Vargas Boyer | Family Medicine | 1001 E Johnson St, Melissa Memorial Hospital, Holyoke, CO 80734 | 2014-06-17 |
| 1881824225 | Jaehyun Byun | Family Medicine | 230 Maple St, Holyoke, MA 01040-5144 | 2009-07-20 |
| Find all providers in HOLYOKE | ||||
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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.