Individual provider Active NPI

Kim Marie Feldhaus

  • Emergency Medicine Physician
  • Boulder, CO
National Provider Identifier
1194700195
Registry record updated May 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
30447 Issued in CO
Practice address
1100 Balsam Ave
Boulder, CO 80304-3404
Phone
(303) 440-2037
Fax
(303) 306-7753
NPI assigned
Dec 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 30447 CO Primary

Addresses

Primary practice location

1100 Balsam Ave
Boulder, CO 80304-3404

Mailing address

PO Box 173894
Denver, CO 80217-3894
Phone (303) 306-7783

Other identifiers 1

IdentifierTypeStateIssuer
01304476MedicaidCO

Other names 1

  • Kim Feldhaus Professional name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20101027000169 CO Practitioner - Emergency Medicine 8628262342 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30447COMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Community Health CurrentSince Aug 1, 2016 Accepting new patients
Boulder Community Health Current Accepting new patients
Boulder Community Health Emergency Medicine CurrentSince Aug 1, 2016 Accepting new patients
Boulder Emergency Physicians PC Emergency Medicine CurrentSince May 1, 2003 Accepting new patients
Boulder Emergency Physicians PC Emergency Medicine CurrentSince May 1, 2003 Accepting new patients
Colorado Permanente Medical Group, P.C. Emergency Medicine Past Accepting new patients
Boulder Community Health Past Accepting new patients

Locations

4747 Arapahoe Ave
Boulder, CO 80303
Phone (303) 415-7000

4801 Riverbend Rd
Ste 300
Boulder, CO 80301
Phone (303) 415-8621

1100 Balsam Ave
Boulder, CO 80304
Phone (303) 415-7000

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369872000000",
    "number": "1194700195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 173894",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802173894",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BALSAM AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043404",
            "telephone_number": "303-440-2037",
            "fax_number": "303-306-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDHAUS",
        "first_name": "KIM",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2013-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "30447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01304476",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "FELDHAUS",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.