Kathryn A Vidlock Granley, MD

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

52345 Issued in CO

Practice address

12760 Stroh Ranch Way Ste 202
Parker, CO 80134-7507

Phone

(720) 851-5420

Fax

(720) 851-5801

NPI assigned

Jun 2, 2006

Last updated

Aug 12, 2019By 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 2

Addresses

Other names 1

• Mrs. Kathryn A Vidlock Professional name

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16409/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/8078/brand/1/csg/1/fhir/r4
• Direct secure messaging: kathryn.vidlock.1@8078.direct.athenahealth.com

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.

• Rocky Mountain Sports Medicine Inc.

  • Sports Medicine (Family Medicine) Physician
  • Parker, CO
  • NPI 1588210934
  Authorized official Same address or phone
• Colorado Orthopaedics PC

  • Orthopaedic Surgery Physician
  • Colorado Springs, CO
  • NPI 1255728861
  NPD (past)
• Rocky Vista Health Center LLC

  • Family Medicine Physician
  • Englewood, CO
  • NPI 1366606709
  NPD (past)

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1184662272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12760 STROH RANCH WAY STE 202",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801347507",
            "telephone_number": "720-851-5420",
            "fax_number": "720-851-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12760 STROH RANCH WAY STE 202",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801347507",
            "telephone_number": "720-851-5420",
            "fax_number": "720-851-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDLOCK GRANLEY",
        "first_name": "KATHRYN",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "52345",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CO",
            "license": "52345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Parker",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12760 Stroh Ranch Way Ste 202",
            "city": "Parker",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801347507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "VIDLOCK",
            "middle_name": "A",
            "prefix": "MRS.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Verbal Behavior Solutions of the Rockies, LLC
• Sarah L. Verretta
• Alan David Verrill, MD
• Susan Vicksman, M.S., CCC-SLP
• Vida Orthodontics
• Deimys Daily Vigil, PMHNP
• Shaylyn Vigil
• Vikas Trivedi DDS PLLC (Parker Dental Studio)
• Jamie Lee Villante, MSN, FNP-BC
• Jennifer Ann Villanueva

• Sports Medicine (Family Medicine) Physician in Parker, CO
• Providers in Parker, CO by specialty
• Sports Medicine (Family Medicine) Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.

Verify at the official NPI Registry.