Individual provider Active NPI

Shauna Marie Gulley, M.D.

  • Internal Medicine Physician
  • Parker, CO
National Provider Identifier
1356553879
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
47832 Issued in CO
Practice address
11960 Lioness Way Ste 190
Parker, CO 80134-5640
Phone
(720) 321-3500
Fax
(720) 321-3501
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 77364 AZ
Pediatrics Physician 208000000X 47832 CO
Internal Medicine Physician 207R00000X 47832 CO Primary

Addresses

Primary practice location

11960 Lioness Way Ste 190
Parker, CO 80134-5640

Mailing address

PO Box 801106
Kansas City, MO 64180-1106
Phone (800) 953-0104

Other practice location 1

9403 Crown Crest Blvd Ste 300
Parker, CO 80138-9048
Phone (303) 269-4410

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090911000533 CO Practitioner - Internal MedicinePractitioner - Pediatric Medicine 8022163294 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
77364AZMDInternal Medicine Physician
47832COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince Nov 1, 2023 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Portercare Adventist Health System CurrentSince Aug 1, 2009 Accepting new patients
Portercare Adventist Health System CurrentSince Aug 1, 2009 Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Nov 1, 2023 Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

11960 Lioness Way
Ste 190
Parker, CO 80134
Phone (303) 649-3790

9403 Crown Crest Blvd
Ste 300
Parker, CO 80138
Phone (303) 269-4410

9399 Crown Crest Blvd
Ste 200
Parker, CO 80138
Phone (303) 269-4410

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 6

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1356553879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801106",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801106",
            "telephone_number": "800-953-0104",
            "fax_number": "303-765-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11960 LIONESS WAY STE 190",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801345640",
            "telephone_number": "720-321-3500",
            "fax_number": "720-321-3501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9403 Crown Crest Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "801389048",
            "country_code": "US",
            "telephone_number": "303-269-4410",
            "fax_number": "303-269-4411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GULLEY",
        "first_name": "SHAUNA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "77364",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "47832",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "47832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

Verify at the official NPI Registry.