Individual provider Active NPI

Heather Dahm Nobles, PA-C

  • Physician Assistant
  • Pagosa Springs, CO
National Provider Identifier
1275903429
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
95 S Pagosa Blvd
Pagosa Springs, CO 81147-8329
Phone
(970) 731-3700
Fax
(970) 731-0511
NPI assigned
Sep 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

95 S Pagosa Blvd
Pagosa Springs, CO 81147-8329

Mailing address

7777 W 38TH Ave Unit A118
Wheat Ridge, CO 80033-6170

Other names 1

  • Heather Christine Dahm Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address heathernobles@psmedicalcenter.cernerdirect.com

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20151114000154 CO Practitioner - Physician Assistant 7214247667 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC CurrentSince Jan 8, 2018 Accepting new patients
Upper San Juan Health Service District CurrentSince Jan 25, 2023 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jan 8, 2018 Accepting new patients

Locations

95 S Pagosa Blvd
Pagosa Springs, CO 81147
Phone (970) 731-3700

7777 W 38th Ave
Unit A
Wheat Ridge, CO 80033

7777 W 38th Ave
Unit A118
Wheat Ridge, CO 80033
Phone (303) 584-8300

Interoperability endpoints

  • Direct secure messaging: heathernobles@psmedicalcenter.cernerdirect.com

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1275903429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 W 38TH AVE UNIT A118",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 S PAGOSA BLVD",
            "city": "PAGOSA SPRINGS",
            "state": "CO",
            "postal_code": "811478329",
            "telephone_number": "970-731-3700",
            "fax_number": "970-731-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLES",
        "first_name": "HEATHER",
        "middle_name": "DAHM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-30",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "heathernobles@psmedicalcenter.cernerdirect.com",
            "affiliation": "N",
            "address_1": "95 S Pagosa Blvd",
            "city": "Pagosa Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "811478329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "DAHM",
            "middle_name": "CHRISTINE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pagosa Springs, CO

Sources for this page

Verify at the official NPI Registry.