Active NPI
Sara Shelton Kerley, M.D.
- Family Medicine Physician
- Colorado Springs, CO
National Provider Identifier
1932388642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 56619
- Practice address
- 215 S Parkside Dr Ste 215
Colorado Springs, CO 80910-3131 - Phone
- (303) 338-4545
- NPI assigned
- Oct 30, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 25MA10235100 | NJ | |
| Family Medicine Physician | 207Q00000X | 0101241868 | VA | |
| Family Medicine Physician | 207Q00000X | 56619 | CO | Primary |
Addresses
Primary practice location
215 S Parkside Dr Ste 215
Colorado Springs, CO 80910-3131
Mailing address
10350 E Dakota Ave
Denver, CO 80247-1314
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 027728 | Other | CO | KAISER COMMERCIAL NUMBER |
| 48770507 | Medicaid | CO |
Other names 1
- Sara Shelton
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56619 | CO | MD | Family Medicine Physician |
| 0101241868 | VA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624060800000",
"number": "1932388642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10350 E DAKOTA AVE",
"city": "DENVER",
"state": "CO",
"postal_code": "802471314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 S PARKSIDE DR STE 215",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809103131",
"telephone_number": "303-338-4545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERLEY",
"first_name": "SARA",
"middle_name": "SHELTON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-30",
"last_updated": "2021-06-19",
"certification_date": "2021-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NJ",
"license": "25MA10235100",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VA",
"license": "0101241868",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "56619",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER COMMERCIAL NUMBER",
"identifier": "027728",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "48770507",
"state": "CO"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "215 S Parkside Dr Ste 215",
"city": "Colorado Springs",
"state": "CO",
"country_code": "US",
"postal_code": "809103131",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "SARA",
"last_name": "SHELTON",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.