Kellie Ann Douglas, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

5007234 Issued in NC

Practice address

4545 E 9TH Ave Ste 260
Denver, CO 80220

Phone

(303) 320-7366

NPI assigned

Oct 29, 2013

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1063840171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 SHEA CENTER DR STE 301",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292251",
            "telephone_number": "303-320-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 E 9TH AVE STE 260",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80220",
            "telephone_number": "303-320-7366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9137 Ridgeline Blvd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Highlands Ranch",
            "state": "CO",
            "postal_code": "801292394",
            "country_code": "US",
            "telephone_number": "303-471-0221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "KELLIE",
        "middle_name": "ANN",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-29",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5007234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER - APN LICENSE",
            "identifier": "993170",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ivor S Douglas, MD
• Jan Jewett Douglas, M.D.
• John Munroe Douglas Jr., M.D.
• Kailen Alexander Douglas, NONE
• Katherine Douglas, PHARMD
• Matthew L Douglas, M.D.
• Jeffrey Madison Douglass, ANP-BC
• Kendra Doukas Wagner, MS, LMFT
• Tricia Ann Doukas, D.D.S.
• Morgan Douthit

• Pediatric Nurse Practitioner in Denver, CO
• Providers in Denver, CO by specialty
• Pediatric Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.