Individual provider Active NPI

Kelly Peter Letourneau, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Lakewood, CO
National Provider Identifier
1285629741
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
43062 Issued in CO
Practice address
1360 S Wadsworth Blvd
208
Lakewood, CO 80232-5415
Phone
(303) 980-1222
Fax
(303) 980-1119
NPI assigned
Sep 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 43062 CO Primary

Addresses

Primary practice location

1360 S Wadsworth Blvd
208
Lakewood, CO 80232-5415

Mailing address

1360 S Wadsworth Blvd
208
Lakewood, CO 80232-5415
Phone (303) 980-1222

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
43062COMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Sky Pain Treatment Center PC Past Accepting new patients

Organizations & group practices 1

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1285629741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 S WADSWORTH BLVD",
            "address_2": "208",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802325415",
            "telephone_number": "303-980-1222",
            "fax_number": "303-980-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 S WADSWORTH BLVD",
            "address_2": "208",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802325415",
            "telephone_number": "303-980-1222",
            "fax_number": "303-980-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETOURNEAU",
        "first_name": "KELLY",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "CO",
            "license": "43062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.