NPIMap

Organization Active NPI

Centennial Eye Associates PLLC

  • Ophthalmology Physician
  • Centennial, CO
National Provider Identifier
1508903220
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
33900 Issued in CO
Legal business name
CENTENNIAL EYE ASSOCIATES PLLC
Practice address
14000 E Arapahoe Rd
Suite 100
Centennial, CO 80112-4043
Phone
(303) 699-3107
Fax
(303) 699-3170
NPI assigned
Jan 31, 2007
Last updated
Feb 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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

Authorized official

Name
Dr. Kim Burrell, D.O.NPI 1053304089
Title
Member
Phone
(303) 699-3107

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1408 CO
Ophthalmology Physician 207W00000X 33900 CO Primary

Addresses

Primary practice location

14000 E Arapahoe Rd
Suite 100
Centennial, CO 80112-4043

Mailing address

14000 E Arapahoe Rd
Suite 100
Centennial, CO 80112-4043
Phone (303) 699-3107

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040921001112 CO Part B Supplier - Clinic/Group Practice 1355319930 Receives reassigned benefits from 4 practitioners
Practice locations: Aurora, CO

National Provider Directory

National Provider Directory

Locations

15901 E Briarwood Cir
Unit 100
Aurora, CO 80016
Phone (303) 662-8400

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202860800000",
    "number": "1508903220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14000 E ARAPAHOE RD",
            "address_2": "SUITE 100",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801124043",
            "telephone_number": "303-699-3107",
            "fax_number": "303-699-3170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14000 E ARAPAHOE RD",
            "address_2": "SUITE 100",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801124043",
            "telephone_number": "303-699-3107",
            "fax_number": "303-699-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL EYE ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2008-02-13",
        "status": "A",
        "authorized_official_last_name": "BURRELL",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "303-699-3107",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1408",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "33900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.