NPIMap

Individual provider Active NPI

Kellee Fitzgerald, CRNA

  • Certified Registered Nurse Anesthetist
  • Colorado Springs, CO
National Provider Identifier
1417126269
Registry record updated Jan 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN.0100009 Issued in CO
Practice address
1400 E Boulder St Ste 2508
Colorado Springs, CO 80909-5533
Phone
(719) 365-6999
Fax
(719) 365-2837
NPI assigned
Feb 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.0128839 CO
Certified Registered Nurse Anesthetist 367500000X APN.0100009 CO Primary

Addresses

Primary practice location

1400 E Boulder St Ste 2508
Colorado Springs, CO 80909-5533

Mailing address

1400 E Boulder St Ste 2508
Colorado Springs, CO 80909-5533
Phone (719) 365-6999

Other identifiers 1

IdentifierTypeStateIssuer
0128839OtherRN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110518000872 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 6002980323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1400 E Boulder St
Suite 2508
Colorado Springs, CO 80909-5533
Phone (719) 365-6999

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.0128839COMDRegistered Nurse
APN.0100009COMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Dec 11, 2017 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Dec 11, 2017 Accepting new patients
Westport Anesthesia Services of Missouri, PC Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

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

1400 E Boulder St
Ste 1183
Colorado Springs, CO 80909
Phone (719) 365-6999

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1400 E Boulder St
Ste 2508
Colorado Springs, CO 80909
Phone (719) 365-1292

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

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.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515456000000",
    "number": "1417126269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E BOULDER ST STE 2508",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095533",
            "telephone_number": "719-365-6999",
            "fax_number": "719-365-2837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E BOULDER ST STE 2508",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095533",
            "telephone_number": "719-365-6999",
            "fax_number": "719-365-2837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "KELLEE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-26",
        "last_updated": "2018-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.0128839",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "APN.0100009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "0128839",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.