Individual provider Active NPI

Kandice Dawn Robinson, PA-C

  • Surgical Physician Assistant
  • Denver, CO
National Provider Identifier
1952790909
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA 0004172 Issued in CO
Practice address
2055 N High St Ste 130
Denver, CO 80205-5504
Phone
(303) 861-2663
Fax
(303) 861-4741
NPI assigned
Jan 14, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA 0004172 CO Primary

Addresses

Primary practice location

2055 N High St Ste 130
Denver, CO 80205-5504

Mailing address

2055 N High St Ste 130
Denver, CO 80205-5504
Phone (303) 861-2663

Other identifiers 1

IdentifierTypeStateIssuer
54656346MedicaidCO

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150212001422 CO Practitioner - Physician Assistant 5294050399

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 0004172COMDSurgical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: kandice.robinson@hca3.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1421193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1952790909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 N HIGH ST STE 130",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802055504",
            "telephone_number": "303-861-2663",
            "fax_number": "303-861-4741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 N HIGH ST STE 130",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802055504",
            "telephone_number": "303-861-2663",
            "fax_number": "303-861-4741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "KANDICE",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-14",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA 0004172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54656346",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.