Kelly Jo Fabrizius, SAC

Primary specialty

SpecialistTaxonomy code 174400000X

License

CO8-0320A Issued in CO

Practice address

200 Exempla Cir
Lafayette, CO 80026-3370

Phone

(970) 674-9766

NPI assigned

Apr 24, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208995200000",
    "number": "1275708844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 MALLARD DR",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805502923",
            "telephone_number": "970-674-9766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EXEMPLA CIR",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263370",
            "telephone_number": "970-674-9766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABRIZIUS",
        "first_name": "KELLY",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "SAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "CO8-0320A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael F Evers, DO
• Evolve Center for Functional Medicine, LLC
• Exempla Good Samaritan Medical Center
• Exempla Good Samaritan Outpatient Pharmacy
• Isaiah Faas
• Jane Heysham Fagan, M.S.
• Laura Churgovich Fahrenbrook, R.PH.
• Sophie Fairmont
• Family Elements Therapy
• Kristy Lynn Faulkner, NP

• Specialist in Lafayette, CO
• Providers in Lafayette, CO by specialty
• Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; 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.