Individual provider Active NPI

Faith Kelley Chenoweth

  • Medical Physician Assistant
  • Wray, CO
National Provider Identifier
1295589810
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.0008655 Issued in CO
Practice address
1017 W 7TH St
Wray, CO 80758-1420
Phone
(970) 332-4811
NPI assigned
Apr 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA.0008655 CO Primary

Addresses

Primary practice location

1017 W 7TH St
Wray, CO 80758-1420

Mailing address

1017 W 7TH St
Wray, CO 80758-1420
Phone (970) 332-4811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240709000081 CO Practitioner - Physician Assistant 1052856614 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Colorado School of Medicine, Aurora, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wray Community District HospitalGroup PAC ID 3274425038, shared by 4 NPIs, 31 clinicians

Practice addresses (Care Compare)

1017 W 7TH St
Wray, CO 80758-1420
Phone (970) 332-4811

700 Main St
Wray, CO 80758-1739
Phone (970) 332-3450

Hospital & facility affiliations

  • Wray Community District Hospital Hospital, Wray, CO, CCN 061309
  • Yuma District Hospital Hospital, Yuma, CO, CCN 061315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0008655COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wray Community District Hospital Past Accepting new patients
Wray Community District Hospital Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1295589810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 W 7TH ST",
            "city": "WRAY",
            "state": "CO",
            "postal_code": "807581420",
            "telephone_number": "970-332-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 W 7TH ST",
            "city": "WRAY",
            "state": "CO",
            "postal_code": "807581420",
            "telephone_number": "970-332-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENOWETH",
        "first_name": "FAITH",
        "middle_name": "KELLEY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0008655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wray, CO

Sources for this page

Verify at the official NPI Registry.