Active NPI
Donald L. Kellum, M.D.
- Ophthalmology Physician
- Louisville, CO
National Provider Identifier
1508133174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 15281
- Practice address
- 410 Orchard Dr
Louisville, CO 80027-3248 - Phone
- (720) 890-7891
- NPI assigned
- Nov 25, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 15281 | CO | Primary |
Addresses
Primary practice location
410 Orchard Dr
Louisville, CO 80027-3248
Mailing address
410 Orchard Dr
Louisville, CO 80027-3248
Phone (720) 890-7891
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15281 | CO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322179200000",
"number": "1508133174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 ORCHARD DR",
"city": "LOUISVILLE",
"state": "CO",
"postal_code": "800273248",
"telephone_number": "720-890-7891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 ORCHARD DR",
"city": "LOUISVILLE",
"state": "CO",
"postal_code": "800273248",
"telephone_number": "720-890-7891"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLUM",
"first_name": "DONALD",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-25",
"last_updated": "2011-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CO",
"license": "15281",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.