Active NPI
Kayla Rose McConnaha
- Student in an Organized Health Care Education/Training Program
- Fort Collins, CO
National Provider Identifier
1104678622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 2260 W Trilby Rd
Fort Collins, CO 80526-9650 - Phone
- (970) 494-4200
- NPI assigned
- Apr 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
2260 W Trilby Rd
Fort Collins, CO 80526-9650
Mailing address
4856 Innovation Dr
Fort Collins, CO 80525-5539
Phone (970) 494-4200
Other practice location 1
1025 Pennock Pl
Fort Collins, CO 80524-3250
Phone (970) 495-8800
Other names 1
- Kayla Rose Lentz
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240716005058 | CO | Order and Referring Only - Family Practice | 1557806320 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783468800000",
"number": "1104678622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4856 INNOVATION DR",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805255539",
"telephone_number": "970-494-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2260 W TRILBY RD",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805269650",
"telephone_number": "970-494-4200"
}
],
"practiceLocations": [
{
"address_1": "1025 Pennock Pl",
"address_purpose": "LOCATION",
"city": "Fort Collins",
"state": "CO",
"postal_code": "805243250",
"country_code": "US",
"telephone_number": "970-495-8800",
"fax_number": "970-495-8891",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCCONNAHA",
"first_name": "KAYLA",
"middle_name": "ROSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-05",
"last_updated": "2026-07-08",
"certification_date": "2026-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KAYLA",
"last_name": "LENTZ",
"middle_name": "ROSE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.