Kelly Deidel, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2265 Issued in CO

Practice address

9094 E Mineral Cir
Suite 100
Centennial, CO 80112-7200

Phone

(303) 694-3200

Fax

(303) 694-2680

NPI assigned

Feb 8, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kdeidel3317@direct.childrenscolorado.org

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.

• Children'S Hospital Colorado

  • Clinical Social Worker
  • Aurora, CO
  • NPI 1174282776
  NPD
• Greenwood Pediatrics PC

  • Primary Care Clinic/Center
  • Centennial, CO
  • NPI 1619013448
  NPD (past)
• Greenwood Pediatrics PC

  • Primary Care Clinic/Center
  • Littleton, CO
  • NPI 1831792233
  NPD (past)

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502064000000",
    "number": "1891836433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9094 E MINERAL CIR",
            "address_2": "SUITE 100",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801127200",
            "telephone_number": "303-694-3200",
            "fax_number": "303-694-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9094 E MINERAL CIR",
            "address_2": "SUITE 100",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801127200",
            "telephone_number": "303-694-3200",
            "fax_number": "303-694-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEIDEL",
        "first_name": "KELLY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2017-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "2265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Dianne Degrush, FNP-BC
• Meghan Amanda Deherrera, OTR/L
• Nicole Deherrera
• Nasim Dehkordi, PHARMD
• Kirsten Paige Dehmlow, CLD, CCCE
• Eric R. Deines, PT, DPT
• Katherine M Deines, PT, DPT, NCS
• Jennifer Deir, N.D.
• Kelly Dekalb, P.T.
• Mary Annette Dekowzan, CMT

• Medical Physician Assistant in Centennial, CO
• Providers in Centennial, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2017; 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.