Active NPI
Sharon Sue Kelly, DO
- Anatomic Pathology & Clinical Pathology Physician
- Denver, CO
National Provider Identifier
1184692444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 31623
- Practice address
- 6116 E Warren Ave
Denver, CO 80222-5752 - Phone
- (303) 512-0888
- Fax
- (303) 512-2288
- NPI assigned
- Mar 10, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Blood Banking & Transfusion Medicine Physician | 207ZB0001X | 31623 | CO | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 31623 | CO | Primary |
Addresses
Primary practice location
6116 E Warren Ave
Denver, CO 80222-5752
Mailing address
PO Box 30309
Charleston, SC 29417-0309
Phone (843) 284-3400
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01316231 | Medicaid | CO | |
| 36586269 | Medicaid | NM | |
| 843385 | Medicaid | AZ | |
| Z6603 | Medicaid | UT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31623 | CO | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201651200000",
"number": "1184692444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30309",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294170309",
"telephone_number": "843-284-3400",
"fax_number": "843-566-8780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6116 E WARREN AVE",
"city": "DENVER",
"state": "CO",
"postal_code": "802225752",
"telephone_number": "303-512-0888",
"fax_number": "303-512-2288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "SHARON",
"middle_name": "SUE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-10",
"last_updated": "2008-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "207ZB0001X",
"taxonomy_group": "",
"desc": "Pathology, Blood Banking & Transfusion Medicine",
"state": "CO",
"license": "31623",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "CO",
"license": "31623",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01316231",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "36586269",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "843385",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Z6603",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.