Active NPI
Matthew Killough, PA-C
- Medical Physician Assistant
- Golden, CO
National Provider Identifier
1699149583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA.0002410
- Practice address
- 200 Jefferson County Pkwy
Golden, CO 80401-6008 - Phone
- (303) 271-5434
- NPI assigned
- Nov 16, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA.0002410 | CO | Primary |
Addresses
Primary practice location
200 Jefferson County Pkwy
Golden, CO 80401-6008
Mailing address
790 N Washington St
#406
Denver, CO 80203-3741
Phone (229) 254-1132
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3580 | TN | MD | Mental Health Counselor |
| PA.0002410 | CO | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447632000000",
"number": "1699149583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 N WASHINGTON ST",
"address_2": "#406",
"city": "DENVER",
"state": "CO",
"postal_code": "802033741",
"telephone_number": "229-254-1132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 JEFFERSON COUNTY PKWY",
"city": "GOLDEN",
"state": "CO",
"postal_code": "804016008",
"telephone_number": "303-271-5434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILLOUGH",
"first_name": "MATTHEW",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-16",
"last_updated": "2015-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CO",
"license": "PA.0002410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Golden, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.