Kamryn Sholly, DC
Individual provider Active NPI Chiropractor · Westminster, CO
NPI 1043891302 · NPPES record last updated Apr 19, 2021
Key facts
- NPI
- 1043891302
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- CHR.0008368 (CO)
- Practice address
- 5714 W 89TH Ave
Westminster, CO 80031-2869 - Phone
- (719) 649-1274
- NPI assigned
- Apr 19, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Colorado Integrated Care Network LLC
Practice addresses (Care Compare)
1823 Ford St
Suite 35
Golden, CO 80401-2546
Phone (303) 641-2254
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210810001466 | CO | Practitioner - Chiropractic | 1658775895 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles (4 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 100 Chiro Westminster, LLC | Chiropractor | Current |
Accepting new patients |
| 100 Chiro Peterson Three LLC | Chiropractor | Current |
Accepting new patients |
| Colorado Integrated Care Network LLC | Current |
Accepting new patients | |
| Revival Chiropractic | Chiropractor | Current |
Accepting new patients |
Locations
1823 Ford St
Ste 35
Golden, CO 80401
Phone (303) 641-2254
5714 W 89th Ave
Westminster, CO 80031
Phone (303) 469-2236
8670 Wolff Ct
Ste 165
Westminster, CO 80031
Phone (262) 492-2269
Networks
- devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
- CO HMO
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHR.0008368 | CO | Yes |
Addresses
Primary practice location
5714 W 89TH Ave
Westminster, CO 80031-2869
Mailing address
13650 E Colfax Ave Apt 3522
Aurora, CO 80011-6931
Other providers in Westminster, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.