Active NPI
Kelly Colegrove
- Adult Companion
- La Vista, NE
National Provider Identifier
1609591890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- Practice address
- 7821 Terry Dr
La Vista, NE 68128-3943 - Phone
- (402) 898-0463
- NPI assigned
- Oct 10, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Adult Companion | 372600000X | NE | Primary |
Addresses
Primary practice location
7821 Terry Dr
La Vista, NE 68128-3943
Mailing address
420 S Washington St
Papillion, NE 68046-2667
Other practice location 1
8025 S 67th Street Cir
LA Vista, NE 68128-4364
Phone (402) 658-0035
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Papillion la Vista Community Schools | Current | Accepting new patients |
Locations
420 S Washington St
Papillion, NE 68046
Phone (402) 537-6200
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Local Education Agency (LEA)
- Papillion, NE
- NPI 1528729126
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665360000000",
"number": "1609591890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 S WASHINGTON ST",
"city": "PAPILLION",
"state": "NE",
"postal_code": "680462667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7821 TERRY DR",
"city": "LA VISTA",
"state": "NE",
"postal_code": "681283943",
"telephone_number": "402-898-0463"
}
],
"practiceLocations": [
{
"address_1": "8025 S 67th Street Cir",
"address_purpose": "LOCATION",
"city": "LA Vista",
"state": "NE",
"postal_code": "681284364",
"country_code": "US",
"telephone_number": "402-658-0035",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COLEGROVE",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-10",
"last_updated": "2022-10-10",
"certification_date": "2022-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": "NE",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Vista, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.