Renee Kershaw

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

PA.0005803 Issued in CO

Practice address

7200 E Dry Creek Rd Ste F103
Centennial, CO 80112-2571

Phone

(303) 792-3333

NPI assigned

Sep 3, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Heritage Hills Family Medicine, P.C

  • Family Medicine Physician
  • Lone Tree, CO
  • NPI 1023277944

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720915200000",
    "number": "1689222648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 E DRY CREEK RD STE F103",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801122571",
            "telephone_number": "303-792-3333",
            "fax_number": "303-792-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 E DRY CREEK RD STE F103",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801122571",
            "telephone_number": "303-792-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSHAW",
        "first_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-03",
        "last_updated": "2024-07-14",
        "certification_date": "2024-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "CO",
            "license": "PA.0005803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth E Katz MD PC
• Kenneth L Andow, DDS, PC
• Jennifer Kent-Young, RBT
• Katherine Kepple, DPT
• Andrew Fyfe Kerr, PT
• Helene Kessler-David, L.C.S.W.
• Kate Guest Ketchum, MA, LPC
• Brian Thomas Ketterman, MD
• Jasmyne A Kettwick, MAMFT, LMFT
• Kevin J Heinze MD PC

• Addiction Medicine (Family Medicine) Physician in Centennial, CO
• Providers in Centennial, CO by specialty
• Addiction Medicine (Family Medicine) Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.