Individual provider Active NPI

Jeanette Yvonne Kelder, DC

  • Chiropractor
  • Wheat Ridge, CO
National Provider Identifier
1972716447
Registry record updated Jul 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5056 Issued in CO
Practice address
7615 W 38TH Ave
Suite B-107
Wheat Ridge, CO 80033-6172
Phone
(303) 424-0401
NPI assigned
May 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5056 CO Primary

Addresses

Primary practice location

7615 W 38TH Ave
Suite B-107
Wheat Ridge, CO 80033-6172

Mailing address

7615 W 38TH Ave
Suite B-107
Wheat Ridge, CO 80033-6172
Phone (303) 424-0401

Other identifiers 1

IdentifierTypeStateIssuer
COA105921OtherCOGROUP PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040126000608 CO Practitioner - Chiropractic 8921900259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3705 Kipling St
Unit 103
Wheat Ridge, CO 80033-5791
Phone (303) 424-0401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jeanette Y Kelder DC PC Chiropractor CurrentSince Jan 18, 2011 Accepting new patients

Locations

3705 Kipling St
Unit 103
Wheat Ridge, CO 80033
Phone (303) 424-0401

7615 W 38th Ave
Unit B107
Wheat Ridge, CO 80033
Phone (303) 318-2900

Organizations & group practices 1

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311206400000",
    "number": "1972716447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7615 W 38TH AVE",
            "address_2": "SUITE B-107",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336172",
            "telephone_number": "303-424-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7615 W 38TH AVE",
            "address_2": "SUITE B-107",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336172",
            "telephone_number": "303-424-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELDER",
        "first_name": "JEANETTE",
        "middle_name": "YVONNE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2011-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "COA105921",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.