KELLEY L REBERRY (NPI# 1710258579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710258579 |
| Entity Type | Individual |
| Full Name | KELLEY L REBERRY |
| Credential | PAC |
| Practice Address |
125 Rampart Way Suite 100 Denver CO 80230-6429 |
| Practice Telephone | 7208587600 |
| Practice Fax Number | 7208587610 |
| Mailing Telephone | 7208587600 |
| Mailing Fax Number | 7208587610 |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2019-01-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 3760 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 2111 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
125 RAMPART WAY SUITE 100 |
| City | DENVER |
| State | CO |
| Zip Code | 80230-6429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003887738 | Leon Samuel Greos | Specialist | 125 Rampart Way, Suite 200, Denver, CO 80230-6406 | 2006-01-31 |
| 1861702441 | Nicole A Mezo | Specialist | 125 Rampart Way, Suite 200, Denver, CO 80230 | 2010-10-15 |
| 1487804852 | Nicole R Rae | Specialist | 125 Rampart Way, Suite 200, Denver, CO 80230-6406 | 2008-09-23 |
| 1316084205 | Katherine Shuang-chyuang Tsai | Internal Medicine | 125 Rampart Way, Suite 200, Denver, CO 80230-6406 | 2007-01-31 |
| 1598798449 | Joanna Z. Levin | Dentist | 125 Rampart Way, Suite 301, Denver, CO 80230-6406 | 2006-07-07 |
| 1417986134 | Colorado Allergy and Asthma Centers, PC | Specialist | 125 Rampart Way, Suite 200, Denver, CO 80230-6406 | 2006-07-03 |
| 1679545941 | Catherine M Van Kerckhove | Specialist | 125 Rampart Way, Suite 200, Denver, CO 80230-6406 | 2006-02-02 |
| 1912979378 | David S Pearlman | Specialist | 125 Rampart Way, Suite 200, Denver, CO 80230-6406 | 2006-02-01 |
| 1700857109 | Nunthaporn Laoprasert | Specialist | 125 Rampart Way, Suite 200, Denver, CO 80230-6406 | 2006-02-01 |
| 1639140247 | Mark A Ebadi | Specialist | 125 Rampart Way, Suite 200, Denver, CO 80230-6406 | 2006-01-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639786445 | Eating Recovery Center | Psychiatry & Neurology | 8140 E. 5th Ave, Denver, CO 80230 | 2020-09-25 |
| 1871132365 | Denver Rehabilitation Hospital, LLC | Rehabilitation Hospital | 4650 Central Park Blvd., Denver, CO 80230 | 2019-12-31 |
| 1366989691 | Tamara Polk | Registered Nurse | 8299 E Lowry Blvd, Denver, CO 80230 | 2017-01-25 |
| 1457802043 | Eating Recovery Center The Carolinas | Social Worker | 7351 E. Lowry Blvd., Suite 200, Denver, CO 80230 | 2016-10-18 |
| 1740635416 | Jessica Zha | Family Medicine | 1001 Yosemite Street, Denver, CO 80230 | 2016-04-29 |
| 1104284694 | University Physicians Incorporated | Obstetrics & Gynecology | 8111 E Lowry Blvd Ste 250, Denver, CO 80230 | 2016-01-29 |
| 1073984399 | Andy Taha | Transportation Broker | 7355 E 7th Ave, Denver, CO 80230 | 2015-10-13 |
| 1790185106 | State Board for Community Colleges and Occupational Education | Dentist | 1062 Akron Way, Bldg. #753, Denver, CO 80230 | 2014-09-04 |
| 1497162127 | Stacy Morsch | Registered Nurse | 1010 Yosemite Street, Denver, CO 80230 | 2014-07-15 |
| 1609153097 | Kimberly Jo French | Acupuncturist | 2865 S. Colorado Blvd., 105n, Denver, CO 80230 | 2011-11-14 |
| Find all providers in zip 80230 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962001438 | Brian Andrew Kacvinsky | Physician Assistant | 1333 E 17th Ave, Denver, CO 80218-1526 | 2020-10-25 |
| 1346849957 | Brittany Elizabeth Driscoll | Physician Assistant | 3056 S Grape Way, Denver, CO 80222-6810 | 2020-10-23 |
| 1912506528 | Christina Walley | Physician Assistant | 1111 Ash St Apt 701, Denver, CO 80220-3758 | 2020-10-23 |
| 1184223794 | Mckenzie Grace | Physician Assistant | 50 N Clarkson St Apt 205, Denver, CO 80218-3739 | 2020-10-23 |
| 1679183909 | Skye Smock | Physician Assistant | 3704 Dexter St, Denver, CO 80207-1045 | 2020-08-02 |
| 1558982397 | Aubrey Leigh Griffiths | Physician Assistant | 2890 Brighton Blvd Unit 347, Denver, CO 80216-5057 | 2020-05-04 |
| 1629616438 | Danielle Lacy | Physician Assistant | 5033 Tucson Way, Denver, CO 80239-4339 | 2019-12-12 |
| 1811531189 | Valerie C Sarni | Physician Assistant | 5974 Central Park Blvd, Denver, CO 80238-3993 | 2019-10-30 |
| 1578105615 | Mackenzie Dwyer | Physician Assistant | 295 E Speer Blvd Apt 339, Denver, CO 80203-3562 | 2019-10-10 |
| 1871149831 | Miles Saenger | Physician Assistant | 6127 S Hwy 16, Denver, NC 28037-9220 | 2019-08-15 |
| Find all providers in DENVER | ||||
Please comment or provide details below to improve the information on KELLEY L REBERRY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.