Individual provider Active NPI

Kenera Colley, DO

  • Family Medicine Physician
  • Renton, WA
National Provider Identifier
1194468801
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP70154489 Issued in WA
Practice address
200 S 2ND St
Renton, WA 98057-2011
Phone
(425) 277-1311
Fax
(425) 277-1566
NPI assigned
Apr 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 5101028735 MI
Family Medicine Physician 207Q00000X OP70154489 WA Primary
Family Medicine Physician 207Q00000X 5101028735 MI

Addresses

Primary practice location

200 S 2ND St
Renton, WA 98057-2011

Mailing address

955 Powell Ave SW
Renton, WA 98057-2908
Phone (425) 277-1311

Other practice location 1

2606 Hospital Blvd Ste B
Corpus Christi, TX 78405-1804
Phone (361) 902-4789

Other practice location 2

3370 E Jefferson Ave
Detroit, MI 48207-4236
Phone (313) 656-1600

Other practice location 3

600 Elizabeth St # 9B
Corpus Christi, TX 78404-2235
Phone (972) 822-8023

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kcolley29837@healthpoint.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20250707003628 MI Practitioner - Family PracticePractitioner - Sports Medicine 6103330725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

3370 E Jefferson Ave
Detroit, MI 48207-4236
Phone (313) 656-1600

Hospital & facility affiliations

  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101028735MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Jun 20, 2025 Accepting new patients
Henry Ford Health System Current Accepting new patients
Henry Ford Health System Current Accepting new patients
Henr Y Ford Health System Family Medicine CurrentSince Jun 20, 2025 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

3370 E Jefferson Ave
Detroit, MI 48207
Phone (313) 656-1600

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

Interoperability endpoints

  • Direct secure messaging: kcolley1084169@direct.hfhs.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1194468801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 POWELL AVE SW",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572908",
            "telephone_number": "425-277-1311",
            "fax_number": "425-277-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S 2ND ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572011",
            "telephone_number": "425-277-1311",
            "fax_number": "425-277-1566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2606 Hospital Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784051804",
            "country_code": "US",
            "telephone_number": "361-902-4789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3370 E Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482074236",
            "country_code": "US",
            "telephone_number": "313-656-1600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Elizabeth St # 9B",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784042235",
            "country_code": "US",
            "telephone_number": "972-822-8023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLEY",
        "first_name": "KENERA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-20",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MI",
            "license": "5101028735",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP70154489",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101028735",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcolley29837@healthpoint.direct-ci.com",
            "affiliation": "N",
            "address_1": "200 S 2nd St",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980572011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.