Kelly Lynn Dorenkott, MD
Individual provider Active NPI Family Medicine Physician · Usaf Academy, CO
NPI 1477515229 · NPPES record last updated Jul 5, 2016
Key facts
- NPI
- 1477515229
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 43282 (CO)
- Practice address
- 4102 Pinion Dr
10TH Medical Group
Usaf Academy, CO 80840-2502 - Phone
- (719) 333-5124
- Fax
- (719) 333-5048
- NPI assigned
- Apr 5, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43282 | CO | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 43282 | CO | Yes |
Addresses
Primary practice location
4102 Pinion Dr
10TH Medical Group
Usaf Academy, CO 80840-2502
Mailing address
4102 Pinion Dr
10TH Medical Group
Usaf Academy, CO 80840-2502
Phone (719) 333-5124
Other providers in Usaf Academy, CO
- Bruce Lowell Deitsch
- Denver Vamc
- Neva Deschner
- Matthew Diotte
- Patricia Marie Donegan
- Glenn A Dowling
- Kyle Hunter East
- Michael Einhorn
- Robert Lloyd Elwood
- Mark Eulenstein
All providers in Usaf Academy, CO · Family Medicine Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 5, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.