NPIMap

Individual provider Active NPI

Kelly J Pearson, PA

  • Surgical Physician Assistant
  • Wheat Ridge, CO
National Provider Identifier
1326088733
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2057 Issued in CO
Practice address
8550 W 38TH Ave
Suite 205
Wheat Ridge, CO 80033-4300
Phone
(303) 467-8987
Fax
(303) 467-9510
NPI assigned
Jun 7, 2006
Last updated
Dec 7, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 2057 CO Primary

Addresses

Primary practice location

8550 W 38TH Ave
Suite 205
Wheat Ridge, CO 80033-4300

Mailing address

8550 W 38TH Ave
Suite 205
Wheatridge, CO 80033
Phone (303) 425-2797

Other identifiers 2

IdentifierTypeStateIssuer
AB01549OtherCOANTHEM
P00458106OtherCOMEDICARE RAILROAD

Other names 1

  • Kelly J Bailey 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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2057COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Orthopedic Clinic Past Accepting new patients
Bryan G Baer, MD, Prof LLC Past Accepting new patients
Northwest Surgical Associates PC PastSince Apr 1, 2006 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1326088733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 W 38TH AVE",
            "address_2": "SUITE 205",
            "city": "WHEATRIDGE",
            "state": "CO",
            "postal_code": "80033",
            "telephone_number": "303-425-2797",
            "fax_number": "303-467-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 W 38TH AVE",
            "address_2": "SUITE 205",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334300",
            "telephone_number": "303-467-8987",
            "fax_number": "303-467-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "KELLY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "2057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "AB01549",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00458106",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "BAILEY",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wheat Ridge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.