NPIMap

Individual provider Active NPI

Nicole C Kenyon, PA

  • Surgical Physician Assistant
  • Denver, CO
National Provider Identifier
1386949154
Registry record updated Oct 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA-3116 Issued in CO
Practice address
4600 Hale Pkwy
Suite 100
Denver, CO 80220-4020
Phone
(303) 320-5566
Fax
(303) 320-1453
NPI assigned
Jan 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2013

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 PA-3116 CO Primary

Addresses

Primary practice location

4600 Hale Pkwy
Suite 100
Denver, CO 80220-4020

Mailing address

4600 Hale Pkwy
Suite 100
Denver, CO 80220-4020
Phone (303) 320-5566

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)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-3116COMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Philippe a Capraro MD PC PastSince Jun 1, 2015 Accepting new patients

Organizations & group practices 1

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": "1295913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381968000000",
    "number": "1386949154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 HALE PKWY",
            "address_2": "SUITE 100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802204020",
            "telephone_number": "303-320-5566",
            "fax_number": "303-320-1453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 HALE PKWY",
            "address_2": "SUITE 100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802204020",
            "telephone_number": "303-320-5566",
            "fax_number": "303-320-1453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENYON",
        "first_name": "NICOLE",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-25",
        "last_updated": "2013-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA-3116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2013; 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.