Kelli Shanahan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0003985 Issued in CO

Practice address

5000 Crown Blvd
Denver, CO 80239-4378

Phone

(720) 423-5808

Fax

(720) 423-5773

NPI assigned

Jul 13, 2014

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kshanahan258044@direct.dhha.org

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.

• Family Medicine Clinic PC

  • Family Medicine Physician
  • Littleton, CO
  • NPI 1275578247
  NPD
• Denver Health and Hospital Authority

  • Federally Qualified Health Center (FQHC)
  • Denver, CO
  • NPI 1922049014
  NPD (past)

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

{
    "created_epoch": "1405209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1063829968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 CROWN BLVD",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802394378",
            "telephone_number": "720-423-5808",
            "fax_number": "720-423-5773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 CROWN BLVD",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802394378",
            "telephone_number": "720-423-5808",
            "fax_number": "720-423-5773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANAHAN",
        "first_name": "KELLI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-13",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "0003985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08174881",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meghan Shamblen, LCSW
• Daniel John Shamburek, MD
• Sara Shamburg-Donohue, ARNP
• Cary B Shames, DO
• Susan Shamos, PHD
• Makayla Shanahan
• Elizabeth Lucille Shane, PSYD
• Kelsey Shanholtz, B.A.
• Casey Shank, LPC
• Joy Danielle Shank, PT

• Physician Assistant in Denver, CO
• Providers in Denver, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.