NPIMap

Individual provider Active NPI

Kathryn Lonsberry, MPAS

  • Physician Assistant
  • Greeley, CO
National Provider Identifier
1740672583
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0007545 Issued in CO
Practice address
6767 29TH St FL 3
Greeley, CO 80634-5474
Phone
(970) 652-2801
Fax
(970) 652-2827
NPI assigned
Mar 3, 2015
Last updated
Nov 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0007545 CO Primary
Physician Assistant 363A00000X PA.200796 LA

Addresses

Primary practice location

6767 29TH St FL 3
Greeley, CO 80634-5474

Mailing address

2104 Loop Rd Ste C
Winnsboro, LA 71295-3341
Phone (318) 435-6363

Other practice location 1

2104 Loop Rd Ste C
Winnsboro, LA 71295-3341
Phone (318) 435-6363

Other identifiers 2

IdentifierTypeStateIssuer
PA.0007545OtherCOSTATE LICENSE
PA.200796OtherLALICENSE

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
I20221118000014 CO Practitioner - Physician Assistant 2062739998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Texas Southwestern Medical School at Dallas, 2014
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)

1700 N Marion St
Denver, CO 80218-1121
Phone (303) 860-7770

2819 35TH Ave
Greeley, CO 80634-9421
Phone (970) 652-2801

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0007545COMDPhysician Assistant
PA.200796LAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Nov 28, 2022 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Nov 28, 2022 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

2819 35th Ave
Greeley, CO 80634
Phone (970) 652-2801

6767 29th St
Fl 3
Greeley, CO 80634
Phone (970) 652-2801

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2403

Organizations & group practices 2

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 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1425340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1740672583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 LOOP RD STE C",
            "city": "WINNSBORO",
            "state": "LA",
            "postal_code": "712953341",
            "telephone_number": "318-435-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6767 29TH ST FL 3",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345474",
            "telephone_number": "970-652-2801",
            "fax_number": "970-652-2827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2104 Loop Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Winnsboro",
            "state": "LA",
            "postal_code": "712953341",
            "country_code": "US",
            "telephone_number": "318-435-6363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONSBERRY",
        "first_name": "KATHRYN",
        "name_prefix": "Mrs.",
        "credential": "MPAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-03",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0007545",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.200796",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA.0007545",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA.200796",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.