NPIMap

Organization Active NPI

David C Kelsall MD PC

Doing business as Rocky Mountain Ear Center PC

  • Otology & Neurotology Physician
  • Englewood, CO
National Provider Identifier
1306831730
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otology & Neurotology PhysicianTaxonomy code 207YX0901X
License
28228 Issued in CO
Legal business name
DAVID C KELSALL MD PC
Doing business as
Rocky Mountain Ear Center PC
Practice address
601 E Hampden Ave
Suite 430
Englewood, CO 80113-3781
Phone
(303) 783-9220
Fax
(303) 806-6292
NPI assigned
Sep 12, 2005
Last updated
Dec 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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

Authorized official

Name
David C Kelsall, MDNPI 1538219969
Title
Medical Doctor
Phone
(303) 783-9220

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otology & Neurotology Physician 207YX0901X 28228 CO Primary

Addresses

Primary practice location

601 E Hampden Ave
Suite 430
Englewood, CO 80113-3781

Mailing address

601 E Hampden Ave
Suite 430
Englewood, CO 80113-3781
Phone (303) 783-9220

Other identifiers 3

IdentifierTypeStateIssuer
01282284MedicaidCO
P00069393OtherRAILROAD MEDICARE
104545800OtherWYMEDICAID

Other names 1

  • Rocky Mountain Ear Center PC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040403000297 CO Part B Supplier - Clinic/Group Practice 3476546847 Receives reassigned benefits from 6 practitioners
Practice locations: Englewood, CO

National Provider Directory

National Provider Directory

Locations

601 E Hampden Ave
Ste 430
Englewood, CO 80113
Phone (303) 783-9220

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608681600000",
    "number": "1306831730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E HAMPDEN AVE",
            "address_2": "SUITE 430",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133781",
            "telephone_number": "303-783-9220",
            "fax_number": "303-806-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E HAMPDEN AVE",
            "address_2": "SUITE 430",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133781",
            "telephone_number": "303-783-9220",
            "fax_number": "303-806-6292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID C KELSALL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-12",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A",
        "authorized_official_last_name": "KELSALL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "303-783-9220",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "CO",
            "license": "28228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01282284",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00069393",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "104545800",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rocky Mountain Ear Center PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rocky Mountain Ear Center PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Englewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.