Individual provider Active NPI

Kelley G Rogers, NP

  • Women's Health Nurse Practitioner
  • Boulder, CO
National Provider Identifier
1245408111
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
APN.0992120-NP Issued in CO
Practice address
2525 Arapahoe Ave Ste 200
Boulder, CO 80302-6720
Phone
(303) 447-1040
Fax
(303) 447-2882
NPI assigned
Feb 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X RN.1634529 CO
Women's Health Nurse Practitioner 363LW0102X APN.0992120-NP CO Primary

Addresses

Primary practice location

2525 Arapahoe Ave Ste 200
Boulder, CO 80302-6720

Mailing address

701 San Mateo Blvd NE
Albuquerque, NM 87108-1434
Phone (052) 659-5115

Other practice location 1

7735 Wadsworth Blvd Unit D
Arvada, CO 80003-2131
Phone (303) 425-6624

Other identifiers 1

IdentifierTypeStateIssuer
1881743631MedicaidCO

Other names 1

  • Kelley Griffith Former name

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN.0992120-NPCOMDWomen's Health Nurse Practitioner
RN.1634529COMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Care Associates, Inc Past Accepting new patients
Major Hospital Past Accepting new patients

Organizations & group practices 2

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": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1245408111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 SAN MATEO BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871081434",
            "telephone_number": "052-659-5115",
            "fax_number": "505-268-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 ARAPAHOE AVE STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803026720",
            "telephone_number": "303-447-1040",
            "fax_number": "303-447-2882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7735 Wadsworth Blvd Unit D",
            "address_purpose": "LOCATION",
            "city": "Arvada",
            "state": "CO",
            "postal_code": "800032131",
            "country_code": "US",
            "telephone_number": "303-425-6624",
            "fax_number": "303-425-6101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "KELLEY",
        "middle_name": "G",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-13",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CO",
            "license": "RN.1634529",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CO",
            "license": "APN.0992120-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881743631",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY",
            "last_name": "GRIFFITH",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.