EDWIN L BACA (NPI# 1902025935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902025935 |
| Entity Type | Individual |
| Full Name | EDWIN L BACA |
| Credential | M.D. |
| Practice Address |
4323 Integrity Center Pt Colorado Springs CO 80917-1683 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7195912558 |
| Practice Fax Number | 7195912596 |
| Mailing Telephone | 9706244036 |
| Mailing Fax Number | 9704904378 |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2016-07-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | DR.0045333 | CO | Allopathic & Osteopathic Physicians |
| N | 2083X0100X |
Preventive Medicine Specialization: Occupational Medicine |
45333 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 70036586 | 05 |
| Street Address |
4323 INTEGRITY CENTER PT |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80917-1683 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356328454 | Lori L Japp | Physician Assistant | 4323 Integrity Center Pt, Colorado Springs, CO 80917-1683 | 2005-12-29 |
| 1104440973 | Poudre Valley Medical Group, LLC | Preventive Medicine | 4323 Integrity Center Pt, Colorado Springs, CO 80917-1683 | 2020-06-08 |
| 1447724505 | Poudre Valley Medical Group, LLC | Clinic/Center | 4323 Integrity Center Pt, Colorado Springs, CO 80917-1683 | 2019-01-11 |
| 1437657640 | Krystal Rockhold | Nurse Practitioner | 4323 Integrity Center Pt, Colorado Springs, CO 80917-1683 | 2018-01-23 |
| 1407363633 | Jayme Eatough | Physician Assistant | 4323 Integrity Center Pt, Colorado Springs, CO 80917 | 2018-01-09 |
| 1588929913 | Crystal Michealson | Physician Assistant | 4323 Integrity Center Pt, Colorado Springs, CO 80917-1683 | 2012-07-11 |
| 1346514163 | Emily Kristen Burns | Preventive Medicine | 4323 Integrity Center Pt, Colorado Springs, CO 80917-1683 | 2012-02-24 |
| 1023259025 | Integrity Urgent Care | Non-Pharmacy Dispensing Site | 4323 Integrity Center Pt, Colorado Springs, CO 80917-1683 | 2009-03-20 |
| 1912189788 | Integrity Urgent Care, P.C. | Clinic/Center | 4323 Integrity Center Pt, Colorado Springs, CO 80917-1683 | 2007-12-03 |
| 1588703904 | Jean-luc Francois Houlne | Physician Assistant | 4323 Integrity Center Pt, Colorado Springs, CO 80917-1683 | 2007-02-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952910499 | Select Physical Therapy of Colorado Springs Lp | Durable Medical Equipment & Medical Supplies | 5660 Barnes Road, Suite 116, Colorado Springs, CO 80917 | 2020-07-30 |
| 1043796774 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 3475 North Academy Blvd, Colorado Springs, CO 80917 | 2018-07-16 |
| 1598273153 | Ariana Goemaere | Behavior Technician | 3535 Parkmoor Village Dr, Colorado Springs, CO 80917 | 2018-01-17 |
| 1366959769 | Behavioral Health Consultants, Inc. | Clinic/Center | 3210 North Academy Blvd, Suite 3, Colorado Springs, CO 80917 | 2018-01-08 |
| 1558870030 | Falisha Rief | Assistant Behavior Analyst | 2790 North Academy Blvd, Suite 180, Colorado Springs, CO 80917 | 2017-09-27 |
| 1407374655 | Christina Otto | Assistant Behavior Analyst | 2790 North Academy, Suite 180, Colorado Springs, CO 80917 | 2017-09-07 |
| 1992155956 | Georgina Segura | Nurse Practitioner | 5135 Iron Horse Trl, Colorado Springs, CO 80917 | 2016-06-20 |
| 1952685182 | Barbara Hazard Henning | Pharmacist | 3840 N Academy Blvd, Colorado Springs, CO 80917 | 2011-10-06 |
| 1659651412 | Nicole Blakesley | Psychologist | 3264 Vail Pass Drive, Colorado Springs, CO 80917 | 2011-08-25 |
| 1427360254 | Austinbluffs Dental Prof. LLC | Dentist | 3952 North Academy, Colorado Springs, CO 80917 | 2010-07-09 |
| Find all providers in zip 80917 | ||||
| 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 |
|---|---|---|---|---|
| 1285256818 | Summit Primary Care | Family Medicine | 75 Printers Pkwy Ste 200, Colorado Springs, CO 80910-3142 | 2020-05-18 |
| 1902437874 | Optumcare Colorado Springs, LLC | Family Medicine | 3470 Centennial Blvd Ste 210, Colorado Springs, CO 80907-4090 | 2020-01-30 |
| 1487285383 | Optumcare Colorado Springs, LLC | Family Medicine | 3470 Centennial Blvd Ste 215, Colorado Springs, CO 80907-4090 | 2020-01-29 |
| 1568093847 | Optumcare Colorado Springs, LLC | Family Medicine | 3470 Centennial Blvd Ste 205, Colorado Springs, CO 80907-8669 | 2020-01-27 |
| 1699319590 | Front Range Urgent Care, PC | Family Medicine | 6530 S Academy Blvd Ste 105, Colorado Springs, CO 80906-8635 | 2019-11-04 |
| 1669014593 | Neida L. Blondet | Family Medicine | 1380 N Fillmore St, Suite 100, Colorado Springs, CO 80907-6464 | 2019-10-11 |
| 1952942526 | Choondai Asha Ramlall | Family Medicine | 2342 Spring Blossom Dr, Colorado Springs, CO 80910-8106 | 2019-10-03 |
| 1710427174 | Vitality Aesthetics Pllc | Family Medicine | 7680 Goddard St, Suite 100, Colorado Springs, CO 80920-8235 | 2017-03-06 |
| 1477096964 | Home Call Medical LLC | Family Medicine | 3925 Regency Dr, Colorado Springs, CO 80906-4318 | 2016-12-01 |
| 1922558188 | Paladina Health, LLC | Family Medicine | 9965 Federal Dr, Colorado Springs, CO 80921-3822 | 2016-10-11 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80917 |
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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.