Individual provider Active NPI

Kerrie Kim, PA-C

  • Physician Assistant
  • Aurora, CO
National Provider Identifier
1962734012
Registry record updated Aug 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1091551 Issued in CO
Practice address
12605 E 16TH Ave
Aurora, CO 80045-2545
Phone
(720) 848-0000
NPI assigned
Jan 31, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1091551 CO Primary

Addresses

Primary practice location

12605 E 16TH Ave
Aurora, CO 80045-2545

Mailing address

PO Box 110429
Aurora, CO 80042-0429
Phone (303) 493-7000

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
I20131011000428 CO Practitioner - Physician Assistant 0941434690 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthone Carenow Urgent Care LLCGroup PAC ID 3375837339, 55 clinicians

Practice addresses (Care Compare)

11339 S Pikes Peak Dr
Parker, CO 80138-7333
Phone (720) 588-4000

1405 E Evans Ave
Denver, CO 80210-4544
Phone (720) 449-8050

17575 Green Valley Ranch Blvd
Denver, CO 80249-7988
Phone (303) 583-4490

17805 Cottonwood Dr
Unit 101
Parker, CO 80134-3952
Phone (303) 583-4730

3001 Havana St
Denver, CO 80238-4099
Phone (720) 458-6825

5620 S Parker Rd
Aurora, CO 80015-1110
Phone (720) 446-5890

7600 W Quincy Ave
Littleton, CO 80123-2403
Phone (720) 449-8062

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1091551COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Urgent Care PLLC CurrentSince Apr 30, 2018 Accepting new patients
Colorado Urgent Care PLLC CurrentSince Apr 30, 2018 Accepting new patients

Locations

18890 E Hampden Ave
Aurora, CO 80013
Phone (303) 617-1604

Organizations & group practices 5

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": "1264896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1962734012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429",
            "telephone_number": "303-493-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12605 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452545",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KERRIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-31",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1091551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.