Profile - DR.0055064 | |
---|---|
General Disclaimer: The information posted on the Healthcare Professions Profile Program (HPPP) website was provided by applicants for an original license; applicants for reinstatement or reactivation of an existing license; as well as by those individuals renewing a license. While the Division believes the information to be reliable, human or mechanical error remains a possibility, as does the delay in the posting or updating of information. The Division makes no guarantee as to the accuracy or completeness of the information and the information is not verified by the HPPP staff. The Division will take action to obtain compliance with the requirements to provide accurate and timely information as required by law when information is received that indicates information required by law has not been provided or is not accurate.
Availability Disclaimer:
Malpractice Claims Disclaimer: |
|
Name | Robert James Fraser |
Credential | DR.0055064 |
HPPP GLOBAL - Location of Practice | |||||||||||||
Location of Practice |
|||||||||||||
Are you currently practicing in the healthcare profession associated with this profile?
For more information about what must be reported, review Director Policy #3.
|
|||||||||||||
Yes |
|||||||||||||
HPPP GLOBAL - WF Location of Practice If Yes | |||||||||||||
Location of Practice |
|||||||||||||
Add your Practice Locations by clicking the "add" button below. If you already have Practice Locations listed that you need to edit you may click the pencil icon in the "Action" column: You must enter all locations where you practice the field in which you are licensed. Questions #6-#10, are being collected per HB 12-1052. These questions will assist the state in assessing the health professional workforce in your community and will effect the distribution of healthcare workforce practice incentives in under served communities. You are not required to complete questions #6-#10 as a part of your profile submission and your responses to the questions below will not be included in the public search of profiles. Your responses will, however, substantially assist the state in improving access to care within your community. Thank you in advance for your willingness to help improve access to healthcare in Colorado. Please enter the average hours per week of the services below at this location. For questions #6-#10, please enter a zero (0) in the field if it is a service you do not provide so your information will be included in the assessment. |
|||||||||||||
|
|||||||||||||
HPPP - MEDICAL Education and Training | |||||||||||||
Education and Training |
|||||||||||||
Please select the highest level of education received as it pertains to your profession. If your degree is not listed, please select "Foreign Trained" for education outside of the United States or "Other" for a United States degree that is not included.
For more information about what must be reported, review Director Policy #3. |
|||||||||||||
University of Minnesota Medical School |
|||||||||||||
Please enter the year your initial Degree was achieved: Only enter the year in YYYY format
|
|||||||||||||
2013 |
|||||||||||||
HPPP GLOBAL - Other Licenses | |||||||||||||
Other Licenses |
|||||||||||||
Have you ever held, or do you currently hold any other licenses in this profession from any other state, country or province?
For more information about what must be reported, review Director Policy #4. |
|||||||||||||
No |
|||||||||||||
HPPP GLOBAL - Board Certifications | |||||||||||||
Board Certifications |
|||||||||||||
Do you hold any current Board Certifications?
For more information about what must be reported, review Director Policy #4. |
|||||||||||||
Yes |
|||||||||||||
HPPP - MEDICAL Board Certifications if Yes | |||||||||||||
Board Certifications |
|||||||||||||
Please select all Board Certifications as applicable: Only current and active certifications should be included.
|
|||||||||||||
|
|||||||||||||
HPPP GLOBAL - Practice Specialties | |||||||||||||
Practice Specialties |
|||||||||||||
Do you have a practice specialty in which you are appropriately trained and actively practicing?
For more information about what must be reported, review Director Policy #4. |
|||||||||||||
Yes |
|||||||||||||
HPPP - MEDICAL Practice Specialties if Yes | |||||||||||||
Practice Specialties |
|||||||||||||
Please select all Practice Specialties as applicable: If your specialty is not listed, you can select ""Other"" and may provide information in the Optional Narrative section |
|||||||||||||
|
|||||||||||||
HPPP GLOBAL - CO Hospital Affiliations | |||||||||||||
Colorado Hospital Affiliations |
|||||||||||||
Do you have a current affiliation or clinical privileges with any Colorado Hospital? Hospital Affiliations and clinical privileges include locum tenens lasting for longer than six months, teaching positions, and any relationship with a hospital including positions on boards of directors. For more information about what must be reported, review Director Policy #4. |
|||||||||||||
Yes |
|||||||||||||
HPPP GLOBAL - CO Hospital Affiliations if Yes | |||||||||||||
Colorado Hospital Affiliations |
|||||||||||||
Add your Colorado hospital affiliations by clicking the "add" button below. If you already have Colorado hosptial affiliations listed that you need to edit, you may click the pencil icon in the "Action" column:
|
|||||||||||||
|
|||||||||||||
HPPP GLOBAL - Other Hospital Affiliations | |||||||||||||
Other Health Care Facilities and Out of State Hospital Affiliations |
|||||||||||||
Do you have a current affiliation with any healthcare facility or a non-Colorado hospital? Other healthcare facilities can include ambulatory surgery centers and rehabilitation hospitals. Affiliations with non-Colorado hospitals includes locum tenens lasting for longer than six months, teaching positions, and any relationship with a hospital including positions on boards of directors.
For more information about what must be reported, review Director Policy #4. |
|||||||||||||
No |
|||||||||||||
HPPP GLOBAL - Business Ownership | |||||||||||||
Business Ownership |
|||||||||||||
Do you have a current business ownership interest in any healthcare-related business?
For more information about what must be reported, review Director Policy #4. |
|||||||||||||
No |
|||||||||||||
HPPP GLOBAL - Employer | |||||||||||||
Employer |
|||||||||||||
Do you have an employer in the profession in which you are licensed or are applying for a license?
For more information about what must be reported, review Director Policy #3. |
|||||||||||||
Yes |
|||||||||||||
HPPP GLOBAL - Employer if Yes | |||||||||||||
Employer |
|||||||||||||
Add your current Employer(s) by clicking the "add" button below. If you already have employers listed that you need to edit, you may click the pencil icon in the "Action" column: List all current employers. If you work for a temporary agency, please list the agency as your employer. Any changes in employers must be updated within one year of the change. |
|||||||||||||
|
|||||||||||||
HPPP GLOBAL - Employment Contracts | |||||||||||||
Employment Contracts |
|||||||||||||
Do you have a contract with any business whose mission relates to healthcare services or products where the value is greater than $5000 annually? This does not include contracts with insurance providers. Any contract with a hospital, durable medical equipment company or pharmaceutical company must be reported.
For more information about what must be reported, review Director Policy #4. |
|||||||||||||
No |
|||||||||||||
HPPP GLOBAL - Disciplinary Actions | |||||||||||||
Disciplinary Actions |
|||||||||||||
Have you ever had public disciplinary action taken against your license by any board or licensing agency in any state or country?
For more information about what must be reported, review Director Policy #5. |
|||||||||||||
No |
|||||||||||||
HPPP GLOBAL - Restrictions and Suspensions | |||||||||||||
Restrictions and Suspensions |
|||||||||||||
Have you ever entered into any agreement or stipulation to temporarily cease your practice or had a board order issued restricting or suspending your license?
For more information about what must be reported, review Director Policy #5. |
|||||||||||||
No |
|||||||||||||
HPPP GLOBAL - Healthcare Facility Actions | |||||||||||||
Healthcare Facility Actions |
|||||||||||||
Since September 1, 1990, have you had any final actions resulting in involuntary limitations or probationary status on or reduction, nonrenewal, denial, revocation or suspension of medical staff membership or clinical privileges at a hospital or healthcare facility? You are not required to report a precautionary or administrative suspension unless you resigned your medical staff membership or clinical privileges while the suspension was pending.
For more information about what must be reported, review Director Policy #5. |
|||||||||||||
No |
|||||||||||||
HPPP GLOBAL - Termination of Employment | |||||||||||||
Termination of Employment |
|||||||||||||
Have you ever been terminated by an employer for a reason that would be considered a violation of your profession's practice law?
For more information about what must be reported, review Director Policy #5. |
|||||||||||||
No |
|||||||||||||
HPPP GLOBAL - DEA Registration | |||||||||||||
DEA Registration Surrender |
|||||||||||||
Have you ever had to involuntarily surrender your United States Drug Enforcement Agency Administration Registration?
For more information about what must be reported, review Director Policy #5. |
|||||||||||||
No |
|||||||||||||
HPPP GLOBAL - DEA Registration if Yes | |||||||||||||
DEA Registration Surrender |
|||||||||||||
Please provide the year of surrender below. If you have had multiple DEA surrenders, enter the years separated by a comma (,).
|
|||||||||||||
HPPP GLOBAL - Convictions | |||||||||||||
Convictions |
|||||||||||||
Since you were issued a license to practice your profession in any state or country, have you had any final criminal conviction(s) or plea arrangement(s) resulting from the commission or alleged commission of a felony or crime of moral turpitude in any jurisdiction?
For more information about what must be reported, review Director Policy #6. |
|||||||||||||
No |
|||||||||||||
HPPP GLOBAL - Malpractice Claims | |||||||||||||
Malpractice Claims |
|||||||||||||
Since September 1, 1990, have you had any final judgment, entered into a settlement, or paid an arbitration award for malpractice?
For more information about what must be reported, review Director Policy #5. |
|||||||||||||
No |
|||||||||||||
HPPP GLOBAL - Malpractice Carrier Refusal | |||||||||||||
Malpractice Carrier Refusal |
|||||||||||||
Have you been denied liability insurance, or has your liability insurance coverage been limited, restricted or terminated by the insurance carrier? This does not include cancellations or terminations due to non-payment For more information about what must be reported, review Director Policy #5. |
|||||||||||||
No |
|||||||||||||
HPPP GLOBAL - Optional Narrative | |||||||||||||
Optional Narrative |
|||||||||||||
Please provide any information regarding awards and/or recognitions you have received, or charity care you have provided that directly relate to your profession. Please be aware that the Director may remove any information that is not pertinent or may be considered inappropriate.
|
|||||||||||||
HPPP GLOBAL - Attestation | |||||||||||||
Attestation |
|||||||||||||
By submitting this Healthcare Professions Profile to the Division of Professions and Occupations you are attesting that:
|
|||||||||||||
Enter today's date: | |||||||||||||
03/17/2017 |
|||||||||||||