Individual provider Active NPI

Kimberly Kay Larson-Ohlsen, MD

  • Obstetrics & Gynecology Physician
  • Aurora, CO
National Provider Identifier
1750335964
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
38587 Issued in CO
Practice address
1400 S Potomac St
#220
Aurora, CO 80012-4528
Phone
(303) 690-2198
Fax
(303) 369-1807
NPI assigned
May 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 38587 CO Primary

Addresses

Primary practice location

1400 S Potomac St
#220
Aurora, CO 80012-4528

Mailing address

4900 S Monaco St
#210
Denver, CO 80237-3486
Phone (303) 690-2198

Other identifiers 1

IdentifierTypeStateIssuer
80823726MedicaidCO

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
I20050901000931 CO Practitioner - Obstetrics/Gynecology 6103858816 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38587COMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Obstetrics & Gynecology CurrentSince Sep 8, 2020 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 8, 2020 Accepting new patients

Locations

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

4809 Argonne St
Ste 200
Denver, CO 80249
Phone (303) 563-2782

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1750335964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 S MONACO ST",
            "address_2": "#210",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802373486",
            "telephone_number": "303-690-2198",
            "fax_number": "303-369-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S POTOMAC ST",
            "address_2": "#220",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800124528",
            "telephone_number": "303-690-2198",
            "fax_number": "303-369-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON-OHLSEN",
        "first_name": "KIMBERLY",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "38587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80823726",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.