Individual provider Active NPI

Kenneth S Raper, D.O.

  • Family Medicine Physician
  • Peyton, CO
National Provider Identifier
1114999034
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33292 Issued in CO
Practice address
7475 McLaughlin Rd
Peyton, CO 80831-4716
Phone
(719) 495-9994
Fax
(719) 495-9904
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 33292 CO Primary

Addresses

Primary practice location

7475 McLaughlin Rd
Peyton, CO 80831-4716

Mailing address

7475 McLaughlin Rd
Peyton, CO 80831-4716
Phone (719) 495-9994

Other identifiers 1

IdentifierTypeStateIssuer
01332923MedicaidCO

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041220000567 CO Practitioner - Family Practice 2062479249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Nova Southeastern College of Osteo Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pulse Family Acute Care Center, Prof. LLCGroup PAC ID 0840399879, 5 clinicians

Practice addresses (Care Compare)

7475 McLaughlin Rd
Peyton, CO 80831-4716
Phone (719) 495-9994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Pulse Family Acute Care Center, Prof. LLC CurrentSince Feb 27, 2007 Accepting new patients

Locations

7475 McLaughlin Rd
Peyton, CO 80831
Phone (719) 495-9994

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114999034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7475 MCLAUGHLIN RD",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808314716",
            "telephone_number": "719-495-9994",
            "fax_number": "719-495-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7475 MCLAUGHLIN RD",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808314716",
            "telephone_number": "719-495-9994",
            "fax_number": "719-495-9904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPER",
        "first_name": "KENNETH",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "33292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01332923",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peyton, CO

Sources for this page

Verify at the official NPI Registry.