Individual provider Active NPI

Kevin Wendell Coleman, D.O.

  • Family Medicine Physician
  • Rifle, CO
National Provider Identifier
1710977871
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
47061 Issued in CO
Practice address
501 Airport Rd
Rifle, CO 81650-8510
Phone
(970) 625-1100
NPI assigned
Oct 28, 2005
Last updated
Feb 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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 47061 CO Primary

Addresses

Primary practice location

501 Airport Rd
Rifle, CO 81650-8510

Mailing address

501 Airport Rd
Rifle, CO 81650-8510
Phone (970) 625-1100

Other identifiers 2

IdentifierTypeStateIssuer
1710977871OtherNPI
15486265MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address colemank@qhndirect.org Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090122000411 CO Practitioner - Family Practice 7719991728 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand River Hospital DistrictGroup PAC ID 7113837469, shared by 5 NPIs, 79 clinicians

Practice addresses (Care Compare)

201 Sipprelle Dr
Parachute, CO 81635-9234
Phone (970) 625-6462

501 Airport Rd
Rifle, CO 81650-8510
Phone (970) 625-6462

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.89 of 100Reported as apm
Quality
86.88
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47061COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grand River Hospital District Current Accepting new patients
Grand River Hospital District CurrentSince Oct 3, 2010 Accepting new patients
Grand River Hospital District CurrentSince Oct 3, 2010 Accepting new patients
Cardinal Pathology PC Current Accepting new patients
Grand River Hospital District Current Accepting new patients

Locations

201 Sipprelle Dr
Parachute, CO 81635
Phone (970) 285-5731

501 Airport Rd
Rifle, CO 81650
Phone (970) 625-1100

501 Airport Rd
Fl 2
Rifle, CO 81650
Phone (970) 625-1100

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1710977871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 AIRPORT RD",
            "city": "RIFLE",
            "state": "CO",
            "postal_code": "816508510",
            "telephone_number": "970-625-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 AIRPORT RD",
            "city": "RIFLE",
            "state": "CO",
            "postal_code": "816508510",
            "telephone_number": "970-625-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "KEVIN",
        "middle_name": "WENDELL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "47061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1710977871",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15486265",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "colemank@qhndirect.org",
            "affiliation": "N",
            "endpointDescription": "Kevin Coleman Grand River Hospital DIRECT Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "201 Sipprelle Dr",
            "city": "Parachute",
            "state": "CO",
            "country_code": "US",
            "postal_code": "816359234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rifle, CO

Sources for this page

Verify at the official NPI Registry.