Maureen E Kelly, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

45238 Issued in CO

Practice address

4491 Bent Brothers Blvd.
Colorado City, CO 81019-9990

Phone

(719) 595-7525

Fax

(719) 595-7965

NPI assigned

Dec 21, 2005

Last updated

Feb 17, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Genesis Eldercare Physician Services LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Colorado Springs, CO
  • NPI 1801215041
  Medicare reassignment NPD
• Inpatient Consultants of Colorado PC

  • Hospitalist Physician
  • Aurora, CO
  • NPI 1720184690

  Internal Medicine

  Medicare reassignment NPD
• Inpatient Consultants of Colorado PC

  • Podiatrist
  • Englewood, CO
  • NPI 1871892505

  Internal Medicine

  NPD
• Genesis Eldercare Physician Services LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Towson, MD
  • NPI 1699280511
  NPD
• Inpatient Consultants of Colorado, PC

  • Internal Medicine Physician
  • Denver, CO
  • NPI 1538461256
  NPD (past)

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1518943554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 560825",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802560825",
            "telephone_number": "719-595-7580",
            "fax_number": "719-545-0176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4491 BENT BROTHERS BLVD.",
            "city": "COLORADO CITY",
            "state": "CO",
            "postal_code": "810199990",
            "telephone_number": "719-595-7525",
            "fax_number": "719-595-7965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MAUREEN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-21",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "88 214",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "45238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27064",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46323040",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna J Clark, OD
• Pamela Lynn Cook, MA, LPC, NCC
• Digicare Hearing Solutions Inc.
• Greenhorn Health Services PCT
• Hygge Holistic Counseling Inc
• Megan Mack
• Anne Esther Maroney, MS, CCC/SLP
• Mountain Time Physical Therapy PC
• Melanie J. Palcic, M.A.-CCC, SLP
• Poudre Valley Medical Group, LLC (UCHealth Medical Group)

• Internal Medicine Physician in Colorado City, CO
• Providers in Colorado City, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.