ANDREW RICHARD DOMER (NPI# 1841231230) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841231230 |
| Entity Type | Individual |
| Full Name | ANDREW RICHARD DOMER |
| Credential | PA-C |
| Practice Address |
3920 N Union Blvd Ste 330 Colorado Springs CO 80907-4916 |
| Practice Telephone | 7195707272 |
| Practice Fax Number | 7195709030 |
| Mailing Telephone | 7195707272 |
| Mailing Fax Number | 7195709030 |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2015-03-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
4155 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CAQH NUMBER | 11561458 | 01 |
| Street Address |
3920 N UNION BLVD STE 330 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80907-4916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871124057 | Margaret Elizabeth Macnabb | Occupational Therapist | 955 West Fillmore Street, Colorado Springs, CO 80907 | 2020-01-28 |
| 1598300394 | Eric L Peterson | Counselor | 4570 Hilton Pwky, Colorado Springs, CO 80907 | 2019-11-15 |
| 1669020160 | Vcphcs Xii, LLC | Clinic/Center | 4157-4159 Centennial Blvd, Colorado Springs, CO 80907 | 2019-08-28 |
| 1366907123 | Natural Healthcare, LLC | Chiropractor | 3030 N Hancock Ave Suite D, Colorado Springs, CO 80907 | 2019-02-06 |
| 1063981777 | Samuel Ray Porterfield | Social Worker | Pfc Floyd K. Lindstrom Outpatient Clinic, 3141 Centennial Blvd., Colorado Springs, CO 80907 | 2018-11-26 |
| 1982170114 | A Physicians Home Care | Home Health | 905 W Garden of The Gods Rd Suite F, Colorado Springs, CO 80907 | 2018-10-15 |
| 1689196180 | Reena Annetta Manka | Counselor | 888 Garden of The Gods, 150, Colorado Springs, CO 80907 | 2017-07-17 |
| 1356870356 | Solaris Hc Co Inc | Hospice Care, Community Based | 1045 Garden of Gods Rd, Colorado Springs, CO 80907 | 2017-06-05 |
| 1649704826 | Colorado Springs Urological Associates Pllc | Urology | 1644 Medical Center Point, Suite 200, Colorado Springs, CO 80907 | 2017-04-14 |
| 1194274704 | Sarah Lynn Hartman | Dietitian, Registered | 3207 North Academy Blvd, Colorado, CO 80907 | 2016-09-23 |
| Find all providers in zip 80907 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932517307 | Soco Surgical Services | Physician Assistant | 4140 Autumn Heights Dr Unit D, Colorado Springs, CO 80906-5912 | 2014-07-29 |
| 1609117654 | Tracy Andrew Truffin | Physician Assistant | 2955 Professional Pl Ste 100, Colorado Springs, CO 80904-8140 | 2013-03-14 |
| 1487792164 | Sondra Elaine Early | Physician Assistant | 2312 N Nevada Ave Ste 305, Colorado Springs, CO 80907-5318 | 2007-02-02 |
| 1427074434 | Mel I Cohen | Physician Assistant | 3225 International Circle, Suite 100, Colorado Springs, CO 80910 | 2006-07-14 |
| 1194373670 | Caitlin Dierkes | Physician Assistant | 4125 Briargate Pkwy, Colorado Springs, CO 80920-7804 | 2019-08-28 |
| 1528616091 | Integral First Assist Services, LLC | Physician Assistant | 1322 N Academy Blvd Ste 204, Colorado Springs, CO 80909-3320 | 2019-08-28 |
| 1649823196 | Sara Westerhaus, Surgical Assisting, LLC | Physician Assistant | 1322 N Academy Blvd Ste 204, Colorado Springs, CO 80909-3320 | 2019-07-23 |
| 1477072304 | Chelsea Elizabeth Onksen | Physician Assistant | 2222 N Nevada Ave Ste 5017, Colorado Springs, CO 80907-6865 | 2017-09-12 |
| 1629505250 | Teren Wayne Abraham Culbertson | Physician Assistant | 1400 E Boulder St, Colorado Springs, CO 80909-5533 | 2017-05-14 |
| 1366809402 | Julie Cortez | Physician Assistant | 1400 E Boulder St Ste 500, Colorado Springs, CO 80909-5533 | 2016-01-20 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80907 |
Please comment or provide details below to improve the information on ANDREW RICHARD DOMER.
| 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.