DR. BRIAN W DESANTIS (NPI# 1861479024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861479024 |
| Entity Type | Individual |
| Full Name | DR. BRIAN W DESANTIS |
| Credential | PSY.D, |
| Practice Address |
2828 International Cir Suite 140 Colorado Springs CO 80910-3127 |
| Mailing Address |
3205 N Academy Blvd Suite 130 Colorado Springs CO 80917-5147 |
| Practice Telephone | 7196325700 |
| Mailing Telephone | 7196325700 |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2017-04-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
2690 | CO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 64456722 | 05 | |
| CO | MEDICARE NUMBER | COA101696 | 01 |
| Street Address |
2828 INTERNATIONAL CIR SUITE 140 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80910-3127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588662639 | Michael Anthony Reisig | Pediatrics | 2828 International Cir, Suite 140, Colorado Springs, CO 80910-3127 | 2005-07-12 |
| 1891293544 | Melissa Grassi | Dental Hygienist | 2828 International Cir, Colorado Springs, CO 80910-3127 | 2018-01-29 |
| 1518477900 | Tayler Renee Zinanti I | Dental Hygienist | 2828 International Cir, Colorado Springs, CO 80910-3127 | 2017-10-11 |
| 1972955318 | Emily A Kennedy | Dentist | 2828 International Cir, Suite 100, Colorado Springs, CO 80910-3127 | 2016-07-11 |
| 1790137131 | Taylor Kennedy | Dentist | 2828 International Cir, Suite 100, Colorado Springs, CO 80910-3127 | 2016-07-11 |
| 1922460583 | Eona Martin | Dental Hygienist | 2828 International Cir, Colorado Springs, CO 80910-3127 | 2016-03-23 |
| 1841651908 | Laurie Ann Archuletta | Dental Hygienist | 2828 International Cir, Suite 100, Colorado Springs, CO 80910-3127 | 2016-03-16 |
| 1629437157 | Madeline Noss | Dental Hygienist | 2828 International Cir, Suite 100, Colorado Springs, CO 80910-3127 | 2016-02-11 |
| 1851795926 | Anna Vannelli | Dental Hygienist | 2828 International Cir, Suite 100, Colorado Springs, CO 80910-3127 | 2014-10-17 |
| 1316341795 | Meredith Adolf | Dental Hygienist | 2828 International Cir, Suite 100, Colorado Springs, CO 80910-3127 | 2014-10-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952955403 | Marian Lin Mondy | Social Worker | 2909 Wellshire Blvd., Colorado Springs, CO 80910 | 2019-08-01 |
| 1538727474 | Lisa Morales | Audiologist | 3225 International Cir Ste 102, Colorado Springs, CO 80910 | 2019-06-05 |
| 1134617038 | Paul Gross | Counselor | 411 Lakewood Circle Dr, C-204-b, Colorado Springs, CO 80910 | 2018-04-25 |
| 1821502923 | Kathleen Lubos Ambros-dahilig | Dental Assistant | 2240 Gilpin Ave, Colorado Springs, CO 80910 | 2017-11-28 |
| 1508384793 | Shawn Maul | Registered Nurse | 115 S Parkside, Colorado Springs, CO 80910 | 2017-09-07 |
| 1376910521 | Kelley Elizabeth Smith Bouchard | Nurse Practitioner | 3225 International Circle Suite 220, Colorado Springs, CO 80910 | 2015-08-24 |
| 1619353430 | Dr. Steven Alan Gould Dds PC | Dentist | 2859 E. Fountain Blvd, Colorado Springs, CO 80910 | 2015-08-04 |
| 1881029155 | Francis Hammet | Chiropractor | 411 Lakewood Circle A1104, Colorado Springs, CO 80910 | 2013-09-05 |
| 1447697586 | Mcb Clinical Research Centers, LLC | Psychologist | 110 S. Parkside Drive, Colorado Springs, CO 80910 | 2013-05-30 |
| 1417206723 | Augustus Albert Edwards | Case Manager/Care Coordinator | 115 Parkside Drive, Colorado Springs, CO 80910 | 2012-08-31 |
| Find all providers in zip 80910 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891063582 | Marcia L Braden | Psychologist | 214 E Dale St, #110, Colorado Springs, CO 80903-4729 | 2011-12-08 |
| 1609913011 | Marcia L Braden Phd PC | Psychologist | 100 E St Vrain Street, Suite 200, Colorado Springs, CO 80903 | 2007-02-01 |
| 1699258178 | Katherine Wesley | Psychologist | 4090 Briargate Pkwy, Colorado Springs, CO 80920-7815 | 2018-09-11 |
| 1871622142 | Michelle Cleckler | Psychologist | 224 E Willamette Ave, Colorado Springs, CO 80903-1114 | 2007-03-05 |
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|---|---|---|---|---|
| 1174099857 | I Have A Dream Foundation - Colorado | Psychologist | Strive Prep - Ruby Hill, 2626 W. Evans Ave, Denver, CO 80219 | 2018-10-19 |
| 1699217778 | Bradley Kent Jackson | Psychologist | 13123 E 16th Ave # 245, Aurora, CO 80045-7106 | 2016-11-07 |
| 1447614383 | Lauren Shomaker | Psychologist | 410 Pitkin St, 1570 Campus Delivery, Fort Collins, CO 80523-1570 | 2016-04-06 |
| 1811301153 | Rachel Ahern | Psychologist | 1298 Peoria St, Aurora, CO 80011-6206 | 2014-06-15 |
| 1942610258 | Stephanie Miller | Psychologist | 150 W 9th Ave Unit 2115, Denver, CO 80204-4045 | 2014-05-08 |
| 1346650454 | Maribel Hinojosa Psyd LLC | Psychologist | 7200 E Dry Creek Rd Ste G208, Centennial, CO 80112-2575 | 2014-04-29 |
| 1427315613 | Lisa Ann Mcclun | Psychologist | 447 W Columbia Ave, Telluride, CO 81435-9448 | 2012-04-12 |
| 1245523430 | Marcela Torres | Psychologist | 1440 15th Street, Boulder, CO 80309-7106 | 2011-05-19 |
| 1306150727 | Nancy Gary | Psychologist | 5290 E Yale Cir Ste 207, Denver, CO 80222-6933 | 2010-07-27 |
| 1275856890 | Idalia Massa | Psychologist | 12631 E 17th Ave Rm 3408, Blg: Ao1, Ms: F406, Uc School of Medicine, Aurora, CO 80045-2527 | 2010-03-10 |
| Find all providers with the same taxonomy | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80910 |
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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.