DR. KELLY ANN MANDAGERE (NPI# 1255492104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255492104 |
| Entity Type | Individual |
| Full Name | DR. KELLY ANN MANDAGERE |
| Credential | M.D. |
| Practice Address |
892 W South Boulder Rd Louisville CO 80027-2453 |
| Practice Telephone | 3035865200 |
| Practice Fax Number | 3035865201 |
| Mailing Telephone | 3035865200 |
| Mailing Fax Number | 3035865201 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2010-07-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 45001 | CO | Allopathic & Osteopathic Physicians |
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
45001 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 01159305 | 05 | |
| CO | 81287895 | 05 |
| Street Address |
892 W SOUTH BOULDER RD |
| City | LOUISVILLE |
| State | CO |
| Zip Code | 80027-2453 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083696843 | Christopher R Fox | Internal Medicine | 892 W South Boulder Rd, Louisville, CO 80027-2453 | 2005-11-17 |
| 1285101451 | Alpine Center for Diabetes Endocrinology and Metabolism PC | Internal Medicine | 892 W South Boulder Rd, Louisville, CO 80027-2453 | 2018-10-25 |
| 1588817464 | Boulder Endocrinology Physicians | Internal Medicine | 892 W South Boulder Rd, Louisville, CO 80027-2453 | 2008-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144849951 | Fullswift Physiotherapy, Pllc | Physical Therapist | 538 W. Laurel Ct., Louisville, CO 80027 | 2020-04-11 |
| 1265097547 | Amanda Nicole Calzolano | Occupational Therapist | 165 S Mccaslin Blvd, Suite B, Louisville, CO 80027 | 2019-05-02 |
| 1891258273 | Lisa Apel | Counselor | 287 Century Circle, Louisville, CO 80027 | 2019-04-11 |
| 1336622570 | Boulder Neurology and Concussion | Psychiatry & Neurology | 400 Mccaslin Blvd, Suite 200, Louisville, CO 80027 | 2018-09-13 |
| 1568942886 | Alessandra Zapiecki | Occupational Therapist | 1107 W Century Dr, Louisville, CO 80027 | 2018-08-16 |
| 1225539935 | Healing Solutions Inc. | Massage Therapist | 362 S. Mccaslin Blvd., Louisville, CO 80027 | 2018-02-27 |
| 1033618632 | Matthew Mandel | Massage Therapist | 1945 Piper St, Superior, CO 80027 | 2018-02-08 |
| 1740794031 | Elise Nicole Brucks | Speech-Language Pathologist | 1007 Century Drive, Louisville, CO 80027 | 2017-11-22 |
| 1043762859 | Options Treatment, LLC | Counselor | 1068 S. 88th Street, Unit A, Louisville, CO 80027 | 2016-10-27 |
| 1225584071 | Trent Sayers Dental PC | Dentist | 1691 Coalton Rd., Superior, CO 80027 | 2016-08-31 |
| Find all providers in zip 80027 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619162880 | Diabetes & Endocrine Specialists Pllc | Internal Medicine | 330 Townepark Cir Ste 100, Louisville, KY 40243-2352 | 2007-09-11 |
| 1053526038 | Lina Yassine | Internal Medicine | 751 Greenridge Ln, Louisville, KY 40207-1307 | 2007-05-11 |
| 1427137223 | Nisha Roy Varghese | Internal Medicine | 330 Townepark Cir, Suite 100, Louisville, KY 40243-2352 | 2006-11-03 |
| 1114026879 | Delhi Associates | Internal Medicine | 3 Audubon Plaza Dr Ste 430, Louisville, KY 40217-1319 | 2006-09-21 |
| 1316953920 | Harold Edward Bays | Internal Medicine | 3288 Illinois Ave, Suite 101, Louisville, KY 40213-1014 | 2006-08-01 |
| 1538114418 | Kailash C Sabharwal | Internal Medicine | 2355 Poplar Level Rd Ste 301, Louisville, KY 40217-1388 | 2006-05-23 |
| 1083696843 | Christopher R Fox | Internal Medicine | 892 W South Boulder Rd, Louisville, CO 80027-2453 | 2005-11-17 |
| 1427045723 | Stephen Fw Cavanah | Internal Medicine | 2355 Poplar Level Rd, Ste.301, Louisville, KY 40217-1395 | 2005-10-02 |
| 1285101451 | Alpine Center for Diabetes Endocrinology and Metabolism PC | Internal Medicine | 892 W South Boulder Rd, Louisville, CO 80027-2453 | 2018-10-25 |
| 1881192409 | Community Medical Associates, Inc. | Internal Medicine | 1930 Bishop Ln Ste 1017, Louisville, KY 40218 | 2018-01-29 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 80027 |
Please comment or provide details below to improve the information on DR. KELLY ANN MANDAGERE.
| 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.