NPIMap

Individual provider Active NPI

Kara Reynolds

  • Medical Physician Assistant
  • Greeley, CO
National Provider Identifier
1669775672
Registry record updated May 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3137 Issued in CO
Practice address
1800 15TH St
Suite 300
Greeley, CO 80631-4500
Phone
(970) 378-4475
NPI assigned
Dec 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3137 CO Primary

Addresses

Primary practice location

1800 15TH St
Suite 300
Greeley, CO 80631-4500

Mailing address

5224 Cornerstone Dr
Fort Collins, CO 80528-3077
Phone (720) 373-1910

Other identifiers 1

IdentifierTypeStateIssuer
43521835MedicaidCO

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
I20110510000215 CO Practitioner - Physician Assistant 2668658634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
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)

11083 Colorado Blvd
Firestone, CO 80504-5873
Phone (303) 833-8880

1925 Mountain View Ave
Longmont, CO 80501-3128
Phone (303) 776-1234

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010
  • Longs Peak Hospital Hospital, Longmont, CO, CCN 060128
  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119
  • Banner Fort Collins Medical Center Hospital, Fort Collins, CO, CCN 060126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3137COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jul 1, 2024 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jul 1, 2024 Accepting new patients
Banner Greeley Specialists Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1925 Mountain View Ave
Longmont, CO 80501
Phone (303) 776-1234

1925 Mountain View Ave
Fl 3
Longmont, CO 80501
Phone (720) 494-3119

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

Organizations & group practices 3

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.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306195200000",
    "number": "1669775672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5224 CORNERSTONE DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283077",
            "telephone_number": "720-373-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 15TH ST",
            "address_2": "SUITE 300",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806314500",
            "telephone_number": "970-378-4475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "KARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-13",
        "last_updated": "2011-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "3137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43521835",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.