Individual provider Active NPI

Kelly Oldham, NP

  • Family Nurse Practitioner
  • Denver, CO
National Provider Identifier
1033665484
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0992402-NP Issued in CO
Practice address
2130 Stout St
Denver, CO 80205-2827
Phone
(303) 293-2220
NPI assigned
Aug 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0992402-NP CO Primary

Addresses

Primary practice location

2130 Stout St
Denver, CO 80205-2827

Mailing address

2111 Champa St
Denver, CO 80205-2529
Phone (303) 293-2220

Other practice location 1

2810 Quebec St
Denver, CO 80207-2900
Phone (303) 370-5870

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
I20180402000713 CO Order and Referring Only - Nurse Practitioner 3072893825

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Colorado School of Medicine, Denver, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Colorado Coalition for the HomelessGroup PAC ID 7618958687, shared by 8 NPIs, 47 clinicians

Practice addresses (Care Compare)

2111 Champa St
Denver, CO 80205-2529

2130 Stout St
Denver, CO 80205-2827
Phone (303) 293-2220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1033665484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 CHAMPA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052529",
            "telephone_number": "303-293-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 STOUT ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052827",
            "telephone_number": "303-293-2220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2810 Quebec St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802072900",
            "country_code": "US",
            "telephone_number": "303-370-5870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLDHAM",
        "first_name": "KELLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-26",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0992402-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.