Kevin Wanebo, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

45571 Issued in CO

Practice address

University of Colorado at Denver and Health Sciences Ce
4200 E. 9TH Ave.
Denver, CO 80262-0001

Phone

(720) 848-1115

NPI assigned

Jan 26, 2007

Sex

Male

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)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1962558544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 GRAPE ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802204431",
            "telephone_number": "303-333-8174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF COLORADO AT DENVER AND HEALTH SCIENCES CE",
            "address_2": "4200 E. 9TH AVE.",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802620001",
            "telephone_number": "720-848-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANEBO",
        "first_name": "KEVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "45571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frederick S Wamboldt, MD
• Maeson Wampler, RDN, CNSC
• Neil Joseph Wandel
• Wandering Vine Wellness LLC
• Narine Wandrey, MD
• Brian James Wang, PA-C
• Brian Jiun Chiang Wang
• Cynthia S Wang, MD
• Eileen Wang, M.D.
• Jason Wang, MD

• Diagnostic Radiology Physician in Denver, CO
• Providers in Denver, CO by specialty
• Diagnostic Radiology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.