Individual provider Active NPI

Kelli Greenleaf

  • Family Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1326599119
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0992662-NP Issued in CO
Practice address
350 Printers Pkwy
Colorado Springs, CO 80910-3190
Phone
(719) 632-5700
NPI assigned
Oct 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0992662-NP CO Primary

Addresses

Primary practice location

350 Printers Pkwy
Colorado Springs, CO 80910-3190

Mailing address

3205 N Academy Blvd Ste 130
Colorado Springs, CO 80917-5152
Phone (719) 632-5700

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
I20170601000612 CO Practitioner - Nurse Practitioner 0345517066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak Vista Community Health CentersGroup PAC ID 4688583974, 126 clinicians

Practice addresses (Care Compare)

350 Printers Pkwy
Colorado Springs, CO 80910-3190
Phone (719) 632-5700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Vista Community Health Centers CurrentSince Mar 18, 2017 Accepting new patients
Peak Vista Community Health Centers CurrentSince Mar 18, 2017 Accepting new patients
Peak Vista Community Health Centers Past Accepting new patients

Locations

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

350 Printers Pkwy
Colorado Springs, CO 80910
Phone (719) 596-2020

340 Printers Pkwy
Colorado Springs, CO 80910
Phone (719) 228-6635

225 S Union Blvd
Colorado Springs, CO 80910
Phone (719) 344-6304

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873

Interoperability endpoints

  • Direct secure messaging: kelli.greenleaf.p1@direct.peakvista.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1326599119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 N ACADEMY BLVD STE 130",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175152",
            "telephone_number": "719-632-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 PRINTERS PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103190",
            "telephone_number": "719-632-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENLEAF",
        "first_name": "KELLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0992662-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.