Charles A. Kudlauskas, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA0003325 Issued in CO

Practice address

12101 Highway 61
Sterling, CO 80751-8428

Phone

(970) 521-5010

Fax

(970) 521-8815

NPI assigned

Feb 19, 2014

Sex

Male

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Colorado Department of Corrections

  • Prison Health Clinic/Center
  • Sterling, CO
  • NPI 1689562241
  NPD (past)

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1932524451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6000",
            "city": "STERLING",
            "state": "CO",
            "postal_code": "807510600",
            "telephone_number": "970-521-5010",
            "fax_number": "970-521-8815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12101 HIGHWAY 61",
            "city": "STERLING",
            "state": "CO",
            "postal_code": "807518428",
            "telephone_number": "970-521-5010",
            "fax_number": "970-521-8815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDLAUSKAS",
        "first_name": "CHARLES",
        "middle_name": "A.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA0003325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA CERTIFICATION NUMBER",
            "identifier": "1066882",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Annette Knorr, MS
• Jessica Koberstein, RN
• Miranda Koester, RN, BSN, IBCLC
• Katie Lynn Konken
• Cheryl P Kraich, RN
• James Kuemmerle
• Allyson Kvachkoff
• Andie Lacombe
• Emily Anne Lacount, DO
• Michael Duane Lahey, M.D.

• Physician Assistant in Sterling, CO
• Providers in Sterling, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.