Active NPI
Kenneth Wayne Farrell, P.A.-C
- Physician Assistant
- Greeley, CO
National Provider Identifier
1235240557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA16558
- Practice address
- 5881 W 16TH St Ste a
Greeley, CO 80634-2910 - Phone
- (970) 652-2454
- Fax
- (970) 652-2447
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA16558 | CA | Primary |
Addresses
Primary practice location
5881 W 16TH St Ste a
Greeley, CO 80634-2910
Mailing address
2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-4439
Other practice location 1
38780 Trade Center Dr Ste 1C
Palmdale, CA 93551-3641
Phone (661) 947-5600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16558 | Other | CA | PHYSICIAN ASSISTANT BOARD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
901 W Hampden Ave
Unit 103
Englewood, CO 80110-7330
Phone (303) 761-1699
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA16558 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Urgent Care LLC | Current | Accepting new patients | |
| Platte River Medical Clinic LLC | Current | Accepting new patients | |
| Emergency Physicians Urgent Care Inc. | Current | Accepting new patients | |
| Lakeside Medical Associates, a Medical Group, Inc. | Past | Accepting new patients | |
| Quantum Plus LLC | Physician Assistant | Past | Accepting new patients |
Locations
212 Coffee Rd
Ste 100
Bakersfield, CA 93309
Phone (661) 885-6060
9710 Brimhall Rd
Bakersfield, CA 93312
Phone (661) 331-8640
2801 Purcell St
Brighton, CO 80601
Phone (303) 558-0515
3950 W 144th Ave
Broomfield, CO 80023
Phone 3036599700531
Interoperability endpoints
- https://api.platform.athenahealth.com/4045/brand/3/csg/61/fhir/r4
- https://api.platform.athenahealth.com/1922/brand/1/csg/1/fhir/r4
Organizations & group practices 14
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.
-
- Urgent Care Clinic/Center
- Littleton, CO
- NPI 1679163851
-
- Urgent Care Clinic/Center
- Brighton, CO
- NPI 1841579703
-
- Urgent Care Clinic/Center
- Bakersfield, CA
- NPI 1689963845
-
- Psychiatry Physician
- Littleton, CO
- NPI 1982570081
-
- Internal Medicine Physician
- Denver, CO
- NPI 1497076681
-
- Primary Care Clinic/Center
- Aurora, CO
- NPI 1669888764
-
- Internal Medicine Physician
- West Hills, CA
- NPI 1831426642
-
- Urgent Care Clinic/Center
- Sherman Oaks, CA
- NPI 1467849745
-
- Family Medicine Physician
- Palmdale, CA
- NPI 1851849863
-
- Family Medicine Physician
- Brighton, CO
- NPI 1477667244
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700438400000",
"number": "1235240557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
"city": "LOVELAND",
"state": "CO",
"postal_code": "805389071",
"telephone_number": "970-624-4439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5881 W 16TH ST STE A",
"city": "GREELEY",
"state": "CO",
"postal_code": "806342910",
"telephone_number": "970-652-2454",
"fax_number": "970-652-2447"
}
],
"practiceLocations": [
{
"address_1": "38780 Trade Center Dr Ste 1C",
"address_purpose": "LOCATION",
"city": "Palmdale",
"state": "CA",
"postal_code": "935513641",
"country_code": "US",
"telephone_number": "661-947-5600",
"fax_number": "661-947-5900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FARRELL",
"first_name": "KENNETH",
"middle_name": "WAYNE",
"name_prefix": "Mr.",
"credential": "P.A.-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2023-11-20",
"certification_date": "2023-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA16558",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIAN ASSISTANT BOARD",
"identifier": "16558",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greeley, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.