MOLLY BETH PETERLIN (NPI# 1902298771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902298771 |
Entity Type | Individual |
Full Name | MOLLY BETH PETERLIN |
Credential | PA-C |
Practice Address |
1400 E Boulder St Ste 600 Colorado Springs CO 80909-5533 |
Mailing Address |
4101 Indian School Rd Ne Ste 110 Albuquerque NM 87110-3991 |
Practice Telephone | 1970624240 |
Mailing Telephone | 5058411000 |
Enumeration Date | 2015-03-03 |
Last Update Date | 2019-10-04 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363A00000X | Physician Assistant | PA.0005317 | CO | Physician Assistants & Advanced Practice Nursing Providers |
N | 363AM0700X |
Physician Assistant Specialization: Medical |
MA057430 | PA | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA2019-0082 | NM | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
3400 Spruce St, 6 Silverstein, Philadelphia, PA 191044238 | 2156622050 |
Street Address |
1400 E BOULDER ST STE 600 |
City | COLORADO SPRINGS |
State | CO |
Zip Code | 80909-5533 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245217108 | David C Corry | Surgery | 1400 E Boulder St Ste 600, Colorado Springs, CO 80909-5533 | 2005-12-30 |
1477168557 | Poudre Valley Medical Group, LLC | Surgery | 1400 E Boulder St Ste 600, Colorado Springs, CO 80909-5533 | 2020-09-15 |
1659984003 | Poudre Valley Medical Group, LLC | Podiatrist | 1400 E Boulder St Ste 600, Colorado Springs, CO 80909-5533 | 2020-08-26 |
1447769351 | Bartlomiej Lipko | Physician Assistant | 1400 E Boulder St Ste 600, Colorado Springs, CO 80909-5533 | 2017-09-22 |
1982052510 | Renaie Leblond | Physician Assistant | 1400 E Boulder St Ste 600, Colorado Springs, CO 80909-5533 | 2016-05-24 |
1093188773 | Michelle S. Janowsky | Physician Assistant | 1400 E Boulder St Ste 600, Colorado Springs, CO 80909-5533 | 2015-11-03 |
1477983369 | Christopher Dorozynski | Physician Assistant | 1400 E Boulder St Ste 600, Colorado Springs, CO 80909-5533 | 2013-11-14 |
1154671295 | Julie Ann Caballero | Physician Assistant | 1400 E Boulder St Ste 600, Colorado Springs, CO 80909-5533 | 2012-09-17 |
1043570161 | Brett Allen Fair | Surgery | 1400 E Boulder St Ste 600, Colorado Springs, CO 80909 | 2012-05-22 |
1841578069 | Erin Renee Henzler | Physician Assistant | 1400 E Boulder St Ste 600, Colorado Springs, CO 80909-5533 | 2011-07-22 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376173765 | Ascent Health LLC | Community/Behavioral Health | 2608 Palmer Park Blvd., Colorado Springs, CO- COLORADO 80909 | 2020-01-24 |
1639714041 | Peak Vista Community Health Centers | Clinic/Center | 4041 E San Miguel St, Colorado Springs, CO 80909 | 2019-11-08 |
1437706231 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 445 N Circle Drive, Colorado Springs, CO 80909 | 2019-08-26 |
1760952964 | James Garofalo | Counselor | 2210 E La Salle St Ste 221, Colorado Spgs, CO 80909 | 2018-11-29 |
1144719055 | Autumn Leaves Counseling, LLC | Counselor | 2130 Academy Circle, Suite B, Co Springs, CO 80909 | 2018-05-07 |
1407353642 | Ambulnz Co, LLC | Ambulance | 2420 E Pikes Peak Ave Ste 1001, Colorado Springs, CO 80909 | 2018-04-12 |
1083117998 | Peak Wellness Counseling Service, LLC | Counselor | 2210 E. La Salle Street, Suite 208, Colorado Springs, CO 80909 | 2018-03-16 |
1043740822 | Ande Carol West | Dental Hygienist | 701 Citadel Drive East, Colorado Springs, CO 80909 | 2017-06-14 |
1043748791 | Colorado Springs Pharmacy LLC | Pharmacy | 2224 E. Pikes Peak Ave, Colorado Springs, CO 80909 | 2017-05-25 |
1215484365 | Brittney Nicole Roberts | Physical Therapist | 2201 Lelaray St., Colorado Springs, CO 80909 | 2016-09-07 |
Find all providers in zip 80909 |
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 |
1841231230 | Andrew Richard Domer | Physician Assistant | 3920 N Union Blvd Ste 330, Colorado Springs, CO 80907-4916 | 2006-06-09 |
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 |
Find all providers in COLORADO SPRINGS |
City | COLORADO SPRINGS |
Zip Code | 80909 |
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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.