Active NPI
Andrew Kelly, BOCPD
- Pedorthist
- Denver, CO
National Provider Identifier
1518600139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pedorthist
- License
- C50457
- Practice address
- 2425 S Colorado Blvd Ste 160
Denver, CO 80222-5937 - Phone
- (303) 669-3771
- NPI assigned
- Apr 20, 2022
- 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 |
|---|---|---|---|---|
| Pedorthist | 224L00000X | C50457 | CO | Primary |
Addresses
Primary practice location
2425 S Colorado Blvd Ste 160
Denver, CO 80222-5937
Mailing address
2425 S Colorado Blvd Ste 160
Denver, CO 80222-5937
Phone (303) 669-3771
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C50457 | CO | MD | Pedorthist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650412800000",
"number": "1518600139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2425 S COLORADO BLVD STE 160",
"city": "DENVER",
"state": "CO",
"postal_code": "802225937",
"telephone_number": "303-669-3771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 S COLORADO BLVD STE 160",
"city": "DENVER",
"state": "CO",
"postal_code": "802225937",
"telephone_number": "303-669-3771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "ANDREW",
"credential": "BOCPD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-04-20",
"last_updated": "2022-04-20",
"certification_date": "2022-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "224L00000X",
"taxonomy_group": "",
"desc": "Pedorthist",
"state": "CO",
"license": "C50457",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.