Kevin Kelley

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

2920 N Academy Blvd Ste 210
Colorado SPGS, CO 80917-5369

Phone

(719) 466-4809

NPI assigned

Jan 23, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1174238299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 N ACADEMY BLVD STE 210",
            "city": "COLORADO SPGS",
            "state": "CO",
            "postal_code": "809175369",
            "telephone_number": "719-466-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 N ACADEMY BLVD STE 210",
            "city": "COLORADO SPGS",
            "state": "CO",
            "postal_code": "809175369",
            "telephone_number": "719-466-4809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kevin.kelley@coloradobehavior.com",
            "affiliation": "N",
            "endpointDescription": "provider email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct provider email for health information",
            "address_1": "2920 N Academy Blvd Ste 210",
            "city": "Colorado Spgs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809175369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Akiesha Kansou
• Jade Kellman
• Lisa B Kemppainen, LMFT
• Jacaya Kennedy
• Kenneth N Coates
• Gary J Klein, M.D.

• Behavior Technician in Colorado SPGS, CO
• Providers in Colorado SPGS, CO by specialty
• Behavior Technician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.