Individual provider Active NPI

Karl G Kohlgraf, DDS, PHD

  • General Practice Dentistry
  • Loveland, CO
National Provider Identifier
1922366038
Registry record updated May 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
202109 Issued in CO
Practice address
302 3Rd St SE Ste 150
Loveland, CO 80537
Phone
(970) 461-8942
Fax
(970) 292-1538
NPI assigned
Apr 26, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 08912 IA
General Practice Dentistry 1223G0001X 202109 CO Primary

Addresses

Primary practice location

302 3Rd St SE Ste 150
Loveland, CO 80537

Mailing address

2930 11TH Ave
Evans, CO 80620-1011
Phone (970) 350-4606

Other practice location 1

1006 A St
Greeley, CO 80631-2021
Phone (970) 352-0048

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180613000668 CO Practitioner - Dentist 1850646928 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202109COMDGeneral Practice Dentistry
08912IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Community Health CurrentSince Jun 11, 2018 Accepting new patients
Sunrise Community Health CurrentSince Jun 11, 2018 Accepting new patients
Sunrise Community Health Current Accepting new patients
Sunrise Community Health Past Accepting new patients

Locations

2930 11th Ave
Evans, CO 80620
Phone (970) 350-4606

1400 37th St
Evans, CO 80620
Phone (970) 348-1112

1006 A St
Greeley, CO 80631
Phone (970) 352-0048

100 N 11th Ave
Greeley, CO 80631
Phone (970) 347-2384

111 E 26th St
Greeley, CO 80631
Phone (970) 702-2675

302 3rd St SE
Ste 150
Loveland, CO 80537
Phone (970) 669-4855

Interoperability endpoints

  • Direct secure messaging: karl.kohlgraf.1@27043.direct.athenahealth.com

Organizations & group practices 4

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": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1922366038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 11TH AVE",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "806201011",
            "telephone_number": "970-350-4606",
            "fax_number": "970-350-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 3RD ST SE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "80537",
            "telephone_number": "970-461-8942",
            "fax_number": "970-292-1538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1006 A St",
            "address_purpose": "LOCATION",
            "city": "Greeley",
            "state": "CO",
            "postal_code": "806312021",
            "country_code": "US",
            "telephone_number": "970-352-0048",
            "fax_number": "970-352-2120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOHLGRAF",
        "first_name": "KARL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DDS, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-26",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08912",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "202109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

Verify at the official NPI Registry.