Agnes Marie Eytchison, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

176415 Issued in CO

Practice address

1010 Three Springs Blvd Ste 200B
Durango, CO 81301-8296

Phone

(709) 764-3390

Fax

(970) 764-3399

NPI assigned

May 12, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Agnes Marie Mayo Former name

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healogics Specialty Physicians of Colorado-Professional, LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Parker, CO
  • NPI 1114331006
  Medicare reassignment NPD
• Healogics Specialty Physicians of Colorado-Professional, LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Lakewood, CO
  • NPI 1114559572
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1205003076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 THREE SPRINGS BLVD",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813018296",
            "telephone_number": "970-764-3775",
            "fax_number": "970-764-3789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 THREE SPRINGS BLVD STE 200B",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813018296",
            "telephone_number": "709-764-3390",
            "fax_number": "970-764-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EYTCHISON",
        "first_name": "AGNES",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "176415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AGNES",
            "last_name": "MAYO",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sean David Evans, LPCC, LPC
• Todd Evinrude, RPH
• Ashleigh Ewing
• Expedient Medical Service
• Eye Care for Durango, LLC
• Tessa Fain, PA
• Mark David Fallon-Cyr, MD
• Maureen Fallon-Cyr, MSW
• Tracy Farmer
• Geoffrey Strider Farnsworth, M.D.

• Family Nurse Practitioner in Durango, CO
• Providers in Durango, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.