NPIMap

Individual provider Active NPI

Adam Lee Kilkenney, D.O.

  • Family Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1467613158
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0060986 Issued in CO
Practice address
5625 N Academy Blvd Ste 1800
Colorado Springs, CO 80918-3658
Phone
(719) 599-0444
Fax
(719) 599-8809
NPI assigned
Jun 24, 2008
Last updated
May 2, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 5101017619 MI
Family Medicine Physician 207Q00000X 5101017619 MI
Family Medicine Physician 207Q00000X DR.0060986 CO Primary

Addresses

Primary practice location

5625 N Academy Blvd Ste 1800
Colorado Springs, CO 80918-3658

Mailing address

5900 Byron Center Ave SW
Attn Medical Administration
Wyoming, MI 49519-9606

Other practice location 1

3912 32nd Ave
Hudsonville, MI 49426-8460
Phone (616) 252-8700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181023002286 CO Practitioner - Family Practice 3779749833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

11083 Colorado Blvd
Firestone, CO 80504-5873
Phone (303) 833-8880

1400 E Boulder
Suite 2410 Pre Procedure Memorial
Colorado Springs, CO 80909-5533
Phone (719) 365-6525

1400 E Boulder St
Colorado Springs, CO 80909-5533

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0060986COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Sep 9, 2018 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 9, 2018 Accepting new patients
Poudre Valley Internists PC Past Accepting new patients
Metropolitan Hospital Past Accepting new patients

Locations

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

5625 N Academy Blvd
Ste 1800
Colorado Springs, CO 80918
Phone (719) 599-0444

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

311 Steele St
Denver, CO 80206
Phone (303) 372-4000

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2403

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1467613158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "address_2": "ATTN MEDICAL ADMINISTRATION",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 N ACADEMY BLVD STE 1800",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183658",
            "telephone_number": "719-599-0444",
            "fax_number": "719-599-8809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3912 32nd Ave",
            "address_purpose": "LOCATION",
            "city": "Hudsonville",
            "state": "MI",
            "postal_code": "494268460",
            "country_code": "US",
            "telephone_number": "616-252-8700",
            "fax_number": "616-252-8750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILKENNEY",
        "first_name": "ADAM",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MI",
            "license": "5101017619",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101017619",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0060986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.