Active NPI
Kenneth Robert Sheridan, DC
- Rehabilitation Chiropractor
- Golden, CO
National Provider Identifier
1184756553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- 4272
- Practice address
- 14828 W 6TH Ave Ste 16B
Golden, CO 80401-5000 - Phone
- (303) 279-0320
- NPI assigned
- Mar 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | 4272 | CO | Primary |
Addresses
Primary practice location
14828 W 6TH Ave Ste 16B
Golden, CO 80401-5000
Mailing address
10885 Linda Vista Dr
Lakewood, CO 80215-1237
Phone (303) 988-3470
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4272 | CO | MD | Rehabilitation Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184756553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10885 LINDA VISTA DR",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802151237",
"telephone_number": "303-988-3470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14828 W 6TH AVE STE 16B",
"city": "GOLDEN",
"state": "CO",
"postal_code": "804015000",
"telephone_number": "303-279-0320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERIDAN",
"first_name": "KENNETH",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "CO",
"license": "4272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Golden, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.