NPIMap

Individual provider Active NPI

Jeffrey Kent, MD

  • Family Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1528014958
Registry record updated Apr 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30970 Issued in CO
Practice address
9480 Briar Village PT
Suite 200
Colorado Springs, CO 80920-7922
Phone
(719) 278-3627
Fax
(719) 623-2101
NPI assigned
May 26, 2006
Last updated
Apr 22, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 30970 CO Primary

Addresses

Primary practice location

9480 Briar Village PT
Suite 200
Colorado Springs, CO 80920-7922

Mailing address

9480 Briar Village PT
Suite 200
Colorado Springs, CO 80920-7922
Phone (719) 278-3627

Other identifiers 1

IdentifierTypeStateIssuer
01309707MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051208000542 CO Practitioner - Family Practice 4688695414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Baylor College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

9480 Briar Village PT
Colorado Springs, CO 80920-7922
Phone (719) 623-2101

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30970COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jan 1, 2018 Accepting new patients
Mountain View Medical Group, PC Past Accepting new patients
Mountain View Medical Group, PC Family Medicine Past Accepting new patients

Locations

9480 Briar Village Pt
Ste 200
Colorado Springs, CO 80920
Phone (719) 278-3627

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1928/brand/1/csg/62/fhir/r4

Organizations & group practices 5

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.

Hospital & facility affiliations 48

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1528014958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9480 BRIAR VILLAGE PT",
            "address_2": "SUITE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207922",
            "telephone_number": "719-278-3627",
            "fax_number": "719-623-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9480 BRIAR VILLAGE PT",
            "address_2": "SUITE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207922",
            "telephone_number": "719-278-3627",
            "fax_number": "719-623-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENT",
        "first_name": "JEFFREY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "30970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01309707",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.