MR. JONATHAN GRAVGAARD (NPI# 1952787764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952787764 |
| Entity Type | Individual |
| Full Name | MR. JONATHAN GRAVGAARD |
| Credential | PA-C |
| Practice Address |
3225 International Cir Suite #100 Colorado Springs CO 80910-3161 |
| Mailing Address |
831 Weber Ridge Pt Colorado Springs CO 80903-7000 |
| Practice Telephone | 7193598812 |
| Mailing Telephone | 6784683068 |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2017-02-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA.0004875 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
2396 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3225 INTERNATIONAL CIR SUITE #100 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80910-3161 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598761348 | John Lawrence Fleming | Psychiatry & Neurology | 3225 International Cir, Suite 100, Colorado Springs, CO 80910-3161 | 2005-06-27 |
| 1245770965 | John L Fleming, Md, Pllc | Psychiatry & Neurology | 3225 International Cir, Suite 100, Colorado Springs, CO 80910-3161 | 2017-02-28 |
| 1700254497 | Cynthia Dawn Burdick | Nurse Practitioner | 3225 International Cir, Ste 220, Colorado Springs, CO 80910-3161 | 2015-09-11 |
| 1962886200 | Victoria Krohn | Nurse Practitioner | 3225 International Cir, Suite 220, Colorado Springs, CO 80910-3161 | 2015-07-16 |
| 1417235011 | Southern Colorado Tms Center, LLC | Clinic/Center | 3225 International Cir, Suite 100, Colorado Springs, CO 80910-3161 | 2011-07-30 |
| 1376714584 | Joseph C Hammock Jr. | Psychologist | 3225 International Cir, Suite 100, Colorado Springs, CO 80910-3161 | 2008-03-14 |
| 1407059330 | New Mexico Gynecology & Fertility Center | Specialist | 3225 International Cir, Suite 100, Colorado Springs, CO 80910-3161 | 2007-06-07 |
| 1093917973 | Chad Abercrombie | Chiropractor | 3225 International Cir, Suite 200, Colorado Springs, CO 80910-3161 | 2007-06-04 |
| 1770700544 | Reproductive Medicine & Fertility Center | Specialist | 3225 International Cir, Suite 100, Colorado Springs, CO 80910-3161 | 2007-04-20 |
| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851726681 | Lisa Kay Adams | Physician Assistant | 525 N Foote Ave Ste 202, Colorado Springs, CO 80909-4501 | 2013-09-11 |
| 1992945208 | Susan Gardiner Cump | Physician Assistant | 2940n Circle Dr, Colorado Springs, CO 80909-1160 | 2009-02-26 |
| 1356591762 | Johnathon D. Kupfner | Physician Assistant | 1584 Jackson Creek Parkway, Ste 120, Colorado Springs, CO 80132 | 2008-09-22 |
| 1427218916 | Gary Patrick Tocci | Physician Assistant | 9310 Sky King Dr, Colorado Springs, CO 80924-2020 | 2008-06-10 |
| 1619144888 | Laurie K Redding | Physician Assistant | 2130 Hollow Brook Dr, Suite 100, Colorado Springs, CO 80918-8400 | 2008-05-15 |
| 1760520746 | Donald Ray Lawson | Physician Assistant | 7667 Steward Ln, Colorado Springs, CO 80922-6327 | 2007-02-02 |
| 1245321140 | Kim Redinger | Physician Assistant | 1740 Pepperwood Dr, Colorado Springs, CO 80910-1525 | 2006-09-27 |
| 1366452401 | Kenneth L Phillips Jr. | Physician Assistant | 15026 La Jolla Pl, Colorado Springs, CO 80921-2564 | 2006-08-09 |
| 1770538159 | Jane D Brockhausen | Physician Assistant | 5799 Stetson Hills Blvd Ste 100, Colorado Springs, CO 80917-4223 | 2006-05-23 |
| 1033173851 | Michael E Young | Physician Assistant | 2222 N Nevada Ave Ste 5011, Colorado Springs, CO 80907-6819 | 2006-04-17 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80910 |
Please comment or provide details below to improve the information on MR. JONATHAN GRAVGAARD.
| 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.