Kelly P Knudson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

46629 Issued in CO

Practice address

300 Exempla Cir
Suite 360
Lafayette, CO 80026-3397

Phone

(303) 689-6560

Fax

(303) 689-6550

NPI assigned

Jan 26, 2007

Last updated

Oct 27, 2010By the provider in NPPES

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 2

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

University of Colorado School of Medicine, Denver, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intermountain Medical Group Denver LLCGroup PAC ID 0840513552, 571 clinicians

Good Samaritan Medical Center, LLCGroup PAC ID 7618995275, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Medical Center LLC Hospital, Lafayette, CO, CCN 060116

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16660/brand/1/csg/1/fhir/r4
• Direct secure messaging: kknudson7012@direct.intermountainhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Good Samaritan Medical Center, LLC

  dba Intermountain Health Good Samaritan Hospital

  • General Acute Care Hospital
  • Lafayette, CO
  • NPI 1043250780

  Surgery

  Medicare reassignment Care Compare group NPD
• Intermountain Medical Group Denver, LLC

  • Family Medicine Physician
  • Denver, CO
  • NPI 1083021083
  Medicare reassignment Care Compare group NPD
• Good Samaritan Medical Center, LLC

  dba Good Samaritan Medical Center

  • General Acute Care Hospital
  • Lafayette, CO
  • NPI 1407845035
  NPD
• Intermountain Medical Group Denver, LLC

  dba Orthopedic Centers of Colorado - Saint Joseph

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Denver, CO
  • NPI 1083598874
  NPD
• Intermountain Medical Group Denver, LLC

  dba SCL Health Medical Group - Lutheran Family Practice

  • Family Medicine Physician
  • Wheat Ridge, CO
  • NPI 1154967719
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Good Samaritan Medical Center, LLC

  dba Good Samaritan Medical Center

  • General Acute Care Hospital
  • Lafayette, CO
  • NPI 1407845035
  Care Compare affiliation

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288137600000",
    "number": "1104972884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 EXEMPLA CIR",
            "address_2": "SUITE 360",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263397",
            "telephone_number": "303-689-6560",
            "fax_number": "303-689-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 EXEMPLA CIR",
            "address_2": "SUITE 360",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263397",
            "telephone_number": "303-689-6560",
            "fax_number": "303-689-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUDSON",
        "first_name": "KELLY",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2010-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "46629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46630597",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00727533",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chante Kline
• Klose Training and Consulting, LLC (Klose Lymphedema Care)
• Jacqueline Kniffen
• Andrew Michael Knight, M.D.
• Amy Rebecca Knudsen, RN
• Karin Maria Knutzen, LCSW
• Julie Eiko Kobayashi-Newberg, LCP
• Melissa Kobs
• Allyson Nicole Kochsmeier, PA-C
• Mary E Koehler, R.N.

• Surgery Physician in Lafayette, CO
• Providers in Lafayette, CO by specialty
• Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.