Kathryn Chmura, M.D.
Individual provider Active NPI Pediatrics Physician · Greeley, CO
NPI 1821344664 · NPPES record last updated Feb 6, 2014
Key facts
- NPI
- 1821344664
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- DR.0052529 (CO)
- Practice address
- 6801 W 20TH St
Suite #201
Greeley, CO 80634-9637 - Phone
- (970) 350-5828
- Fax
- (970) 378-4210
- NPI assigned
- Jul 31, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130919000384 | CO | Practitioner - Pediatric Medicine | 0648414342 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR.0052529 | CO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner Health Physicians Colorado LLC | Current |
Accepting new patients | |
| Banner Health Physicians Colorado LLC | Current |
Accepting new patients | |
| Banner Health Physicians Colorado LLC | Past | Accepting new patients |
Locations
1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121
6801 W 20th St
Unit 201
Greeley, CO 80634
Phone (970) 330-1090
2001 70th Ave
Ste 200
Greeley, CO 80634
Phone (970) 313-0027
2555 E 13th St
Ste 130
Loveland, CO 80537
Phone (970) 663-5437
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | DR.0052529 | CO | Yes |
Addresses
Primary practice location
6801 W 20TH St
Suite #201
Greeley, CO 80634-9637
Mailing address
6801 W 20TH St
Suite #201
Greeley, CO 80634-9637
Phone (970) 350-5828
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25577735 | Medicaid | CO |
Other providers in Greeley, CO
- Kristoffer Childers
- Melynda Joy Childers
- Children'S Dentistry LLC
- Children'S Hospital Colorado
- Tierrah J Chism
- Diane Christensen
- Jennifer L Christensen
- Mary Christensen
- Arwen Christian
- Claire Christian
All providers in Greeley, CO · Pediatrics Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.