Kenneth John Colley, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A69242 Issued in CA

Practice address

2595 Clay St
Ste 5
San Francisco, CA 94115-1864

Phone

(415) 225-5771

NPI assigned

Mar 30, 2009

Last updated

Mar 30, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238371200000",
    "number": "1225270713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 CLAY ST",
            "address_2": "STE 5",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941151864",
            "telephone_number": "415-225-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2595 CLAY ST",
            "address_2": "STE 5",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941151864",
            "telephone_number": "415-225-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLEY",
        "first_name": "KENNETH",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-30",
        "last_updated": "2009-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A69242",
            "primary": true
        },
        {
            "code": "208U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Pharmacology",
            "state": "CA",
            "license": "A69242",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Collentine-Cole
• Dianna Alice Collett
• Gabriela Colletta
• Dirk M Collevecchio, RN, AGNP-C
• Alexis Katherine Krupp Colley, MD
• Kristen Colley, LMFT 130615
• Brian Christopher Colli
• Stephanie R Collier, PA
• Collin P. Quock, M.D., a Medical Corporation
• Collins Care Home

• Internal Medicine Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; 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.