KELLI SHANAHAN


Address: 1860 E Egbert St, Brighton, CO 80601-2475
Phone: 3036972583

KELLI SHANAHAN (NPI# 1063829968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1063829968
Entity Type Individual
Full Name KELLI SHANAHAN
Credential PA-C
Practice Address 1860 E Egbert St
Brighton
CO 80601-2475
Mailing Address 203 S Rollie Ave
Billing Dept - Credentialist
Fort Lupton
CO 80621-1508
Practice Telephone 3036972583
Mailing Telephone 3032864560
Mailing Fax Number 3032864589
Enumeration Date 2014-07-13
Last Update Date 2016-12-01
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant 0003985 CO Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
CO 08174881 05

Office Location

Street Address 1860 E EGBERT ST
City BRIGHTON
State CO
Zip Code 80601-2475

Providers in the same location

NPI Name Taxonomy Address Enumeration
1558368407 Lisa J Ruschak Family Medicine 1860 E Egbert St, Brighton, CO 80601-2475 2005-07-07
1073124590 Alexandra Jean Walkush Physician Assistant 1860 E Egbert St, Brighton, CO 80601-2404 2020-08-10
1861029993 Kristen Nichole Robbins Student in an Organized Health Care Education/Training Program 1860 E Egbert St, Brighton, CO 80601-2404 2020-03-26
1295369361 Ashley Ortiz Student in an Organized Health Care Education/Training Program 1860 E Egbert St, Brighton, CO 80601-2404 2020-02-27
1922661552 Taylor Ashley Foster Student in an Organized Health Care Education/Training Program 1860 E Egbert St, Brighton, CO 80601-2404 2019-04-18
1326538604 Monika Czekalska Student in an Organized Health Care Education/Training Program 1860 E Egbert St, Brighton, CO 80601-2404 2018-05-13
1316392152 Jonathan Daniel Waldmann Family Medicine 1860 E Egbert St, Brighton, CO 80601-2404 2016-04-29
1033575261 Norma Lopez Physician Assistant 1860 E Egbert St, Brighton, CO 80601-2475 2016-01-04
1013324367 Lane Marie Bryant Physician Assistant 1860 E Egbert St, Brighton, CO 80601-2475 2014-07-18
1174940241 Plan De Salud Del Valle Inc Pharmacy 1860 E Egbert St, Brighton, CO 80601-2475 2014-03-26
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1326541228 Dentists of Brighton, LLP Dentist 5127 E Bridge Street, Brighton, CO 80601 2018-03-16
1972038313 Girls Only Ministry Community Based Residential Treatment Facility, Mental Illness 655 North 16th Way, Brighton, CO 80601 2017-04-24
1174074223 Milltown Dialysis LLC Clinic/Center 1321 S 4th Ave Ste 100, Brighton, CO 80601 2016-10-24
1427418953 Alexis Martinez Dental Hygienist 1860 Egbert Street, Brighton, CO 80601 2016-02-25
1427413160 Haile Ogbalidet Pharmacist 1605 E. Bridge St, Brighton, CO 80601 2015-12-23
1841686128 Jamie Nichole Campbell Pediatrics 1606 Prairie Center Parkway Premier Pediatrics, Suite 300, Brighton, CO 80601 2015-04-13
1568881795 Dillon Companies LLC Durable Medical Equipment & Medical Supplies 100 N 50th Ave, Brighton, CO 80601 2014-04-15
1841616554 Rebecca Sholeh Philman Registered Nurse 423 Mt Elbert St, Brighton, CO 80601 2014-03-06
1770928756 Capital Success, LLC Clinic/Center 203 Telluride St Unit 750, Brighton, CO 80601 2013-05-06
1992045884 Kristin Michelle Uchida Massage Therapist 27 S 4th Ave, Brighton, CO 80601 2013-03-01
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1033722822 Natalie Miranda Physician Assistant 35 Henshaw St, Brighton, MA 02135-2927 2020-08-31
1235741067 Karin Sampaio Physician Assistant 5155 Golden Eagle Pkwy, Brighton, CO 80601-8735 2020-08-22
1669090585 Michael Joseph Core Physician Assistant 1626 Commonwealth Ave Apt 11, Brighton, MA 02135-5027 2020-07-07
1609434745 Robert Connell Physician Assistant 36 Orkney Rd Apt 2, Brighton, MA 02135-7712 2019-06-04
1427533603 John Peter Halfen Iv Physician Assistant 2801 Purcell St # 1, Brighton, CO 80601-3551 2018-10-03
1659856805 Kelly Brianne Armstrong Physician Assistant 7500 Challis Rd Fl 2, Brighton, MI 48116-9416 2018-10-03
1538675418 Karen K Minchow Physician Assistant 12000 E Big Cottonwood Canyon Rd, Brighton, UT 84121-9710 2017-12-14
1174068134 Sarah Kolchinsky Physician Assistant 23 Egremont Rd, Apt #4, Brighton, MA 02135-7329 2016-12-30
1669855979 Michelle Cummings Physician Assistant 1945 Commonwealth Ave, #32, Brighton, MA 02135-5963 2015-07-06
1891196895 Steven Barrett Physician Assistant 8718 N Christine Dr, Brighton, MI 48114-4911 2014-09-09
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City BRIGHTON
Zip Code 80601

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Dataset Information

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.

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