Nicholee R Theiss (NPI# 1922049048, PAC ID# 8921030966) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1922049048 |
| PAC ID by PECOS | 8921030966 |
| Professional Enrollment ID | I20080808000351 |
| Full Name | Nicholee R Theiss |
| Organization Legal Name | POTOMAC SQUARE FAMILY MEDICINE LLC |
| Address |
805 S Broadway St Suite 103 Boulder CO 80305-5972 |
| Phone Number | 3034990176 |
| Gender | F |
| Credential | MD |
| Medical School | UNIVERSITY OF WISCONSIN MEDICAL SCHOOL |
| Graduation Year | 2002 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 1557333465 |
| Number of Group Practice Members | 26 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 060027 | BOULDER COMMUNITY HEALTH |
| Address | Phone | Organization |
|---|---|---|
| 805 S Broadway St, Suite 103, Boulder, CO 80305-5972 | 3034990176 | POTOMAC SQUARE FAMILY MEDICINE LLC |
| Organization Legal Name | POTOMAC SQUARE FAMILY MEDICINE LLC |
| Physicians | 36 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sarah Lashley | Physical Therapy | Potomac Square Family Medicine LLC | 730 W Hampden Ave, Englewood, CO 80110-2120 |
| Jovan Mack | Nurse Practitioner | Potomac Square Family Medicine LLC | 605 Parfet St, Suite 103, Lakewood, CO 80215-5518 |
| Lisa E Hawkins | Nurse Practitioner | Potomac Square Family Medicine LLC | 20270 E Smoky Hill Rd, Centennial, CO 80015-3138 |
| Carlos F Vera | Family Medicine | Potomac Square Family Medicine LLC | 6080 W 92nd Ave, Suite 1000, Westminster, CO 80031-2935 |
| Rachel A Bos | Family Medicine | Potomac Square Family Medicine LLC | 805 S Broadway St, Suite 103, Boulder, CO 80305-5972 |
| Leslie W Reitman | Internal Medicine | Potomac Square Family Medicine LLC | 13650 E Mississippi Ave, Aurora, CO 80012-3561 |
| John E Marquez | Physician Assistant | Potomac Square Family Medicine LLC | 13650 E Mississippi Ave, Aurora, CO 80012-3561 |
| Jeromy G Wilson | Physician Assistant | Potomac Square Family Medicine LLC | 13650 E Mississippi Ave, Aurora, CO 80012-3561 |
| Mackenzie A Courtney | Nurse Practitioner | Potomac Square Family Medicine LLC | 13650 E Mississippi Ave, Aurora, CO 80012-3561 |
| Jeffrey R Mills | Physical Therapy | Potomac Square Family Medicine LLC | 13650 E Mississippi Ave, Aurora, CO 80012-3561 |
| Street Address |
805 S BROADWAY ST SUITE 103 |
| City | BOULDER |
| State | CO |
| Zip | 80305-5972 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rachel A Bos | Family Medicine | Potomac Square Family Medicine LLC | 805 S Broadway St, Suite 103, Boulder, CO 80305-5972 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ivan J Miller | Psychologist, Clinical | 350 Broadway St, Suite 210, Boulder, CO 80305-3338 | |
| Celia G Sinoway | Psychologist, Clinical | 350 Broadway, Suite 102, Boulder, CO 80305-3338 | |
| Lauren R Goldsmith | Psychologist, Clinical | 350 Broadway St, Suite 210, Boulder, CO 80305-3338 | |
| Robert Jelinek | Podiatry | 350 Broadway St, Suite 208, Boulder, CO 80305-3338 | |
| Susan H Nofziger | Clinical Social Worker | 350 Broadway St, Suite 205, Boulder, CO 80305-3338 | |
| Eric J Vanzura | Family Medicine | 350 S Broadway St, Suite 100, Boulder, CO 80305-3455 | |
| Karen K Sharer Mohatt | Psychologist, Clinical | 4710 Table Mesa Dr, Suite B, Boulder, CO 80305-4504 | |
| Michael J Kohm | Physical Therapy | 4710 Table Mesa Dr, Suite B, Boulder, CO 80305-4504 | |
| Susan Ollar | Psychologist, Clinical | 3705 Martin Dr, Boulder, CO 80305-5447 | |
| Polly M Mahoney | Clinical Social Worker | 1230 Wildwood Rd, Boulder, CO 80305-5642 | |
| Find all physicians in zip 80305 | |||
| City | BOULDER |
| Zip Code | 80305 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | BOULDER + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Nicholee R Theiss.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.