Kim Renea Draughon, MA

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

2647 Issued in CO

Practice address

8649 W 95TH Dr
Westminster, CO 80021-5322

Phone

(303) 819-6425

NPI assigned

Sep 11, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kim Renea Ruybal Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1770066151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8649 W 95TH DR",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800215322",
            "telephone_number": "303-819-6425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8649 W 95TH DR",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800215322",
            "telephone_number": "303-819-6425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAUGHON",
        "first_name": "KIM",
        "middle_name": "RENEA",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CO",
            "license": "2647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2647",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "RUYBAL",
            "middle_name": "RENEA",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Community/Behavioral Health Agency in Westminster, CO
• Providers in Westminster, CO by specialty
• Community/Behavioral Health Agency in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.