Individual provider Active NPI

Kimberly Ann Cullen

  • Family Medicine Physician
  • Denver, CO
National Provider Identifier
1457746216
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0061033 Issued in CO
Practice address
777 Bannock St
Denver, CO 80204-4597
Phone
(303) 436-4949
Fax
(303) 602-3733
NPI assigned
Mar 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0061033 CO Primary

Addresses

Primary practice location

777 Bannock St
Denver, CO 80204-4597

Mailing address

777 Bannock St
Denver, CO 80204-4597
Phone (303) 436-4949

Other practice location 1

2200 E 104th Ave Ste 115
Thornton, CO 80233-4402
Phone (303) 452-2766

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
I20190204001130 CO Practitioner - Family Practice 6901114479 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Medical Group Colorado PLLC Family Medicine CurrentSince Sep 16, 2024 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jan 7, 2019 Accepting new patients
Denver Health and Hospital Authority CurrentSince Mar 26, 2025 Accepting new patients
Denver Health and Hospital Authority CurrentSince Mar 26, 2025 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jan 7, 2019 Accepting new patients
Denver Health and Hospital Authority Past Accepting new patients

Locations

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

999 17th St
Ste 500
Denver, CO 80202
Phone (720) 355-0539

1700 N Marion St
Denver, CO 80218
Phone (303) 830-6666

4995 E 33rd Ave
Denver, CO 80207
Phone (303) 602-3720

777 Bannock St
Denver, CO 80204

2200 E 104th Ave
Ste 115
Thornton, CO 80233
Phone (303) 452-2766

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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1457746216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-436-4949",
            "fax_number": "303-602-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-436-4949",
            "fax_number": "303-602-3733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 E 104th Ave Ste 115",
            "address_purpose": "LOCATION",
            "city": "Thornton",
            "state": "CO",
            "postal_code": "802334402",
            "country_code": "US",
            "telephone_number": "303-452-2766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CULLEN",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0061033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.