1. Home
  2. Directory
  3. Colorado
  4. Denver
  5. Otolaryngology
  6. NPI Profile

DR. KELLY JOY PETTIJOHN M.D.
NPI 1023451176
Otolaryngology - Plastic Surgery within the Head & Neck in Denver, CO

Active since April 08, 2013PECOS EnrolledAccepts Medicare Assignment
2045 N FRANKLIN ST, DENVER, CO 80205(303) 338-4545(303) 344-7715 Get Directions Write a Review

NPPES record last updated: March 29, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 29, 2021, Aug 31, 2018 (2 updates tracked since 2018).

About Dr. Kelly Joy Pettijohn M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KELLY JOY PETTIJOHN M.D. (NPI 1023451176) is an individual plastic surgery within the head & neck provider in Denver, Colorado, licensed in Colorado (DR.0060683) and active in the NPI registry since April 2013. She is enrolled in Medicare PECOS and is a graduate of University Of Colorado School Of Medicine, Denver (2013).

NPPES Registry Identity

NPI1023451176
Entity TypeIndividualFemale
Primary Taxonomy207YX0007X
Provider Legal NameDR. KELLY JOY PETTIJOHNCredential: M.D.
Location Address2045 N FRANKLIN STDenver, CO 80205
Mailing Address10350 E Dakota AveDenver, CO 80247-1314 · (303) 338-4545 · Fax (303) 344-7715
Phone(303) 338-4545
Fax(303) 344-7715
Sole ProprietorNo
Medical School CMSUniversity Of Colorado School Of Medicine, DenverGraduated 2013
Enumeration DateApril 8, 2013
Last NPPES UpdateMarch 29, 20212 updates tracked since enumeration
NPPES CertifiedMarch 29, 2021
✔ NPI 1023451176 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOtolaryngology · Plastic Surgery within the Head & NeckAllopathic & Osteopathic Physicians
Taxonomy Code207YX0007X
License✔ Licensed in CO · DR.0060683
Definition
An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
2045 N FRANKLIN ST, Denver, CO 80205
Open in Google Maps ↗

Other Identifiers 1

Other028886CO · Kaiser Commercial Number

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kelly Joy Pettijohn M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1850642570
PECOS Enrollment IDI20180919002529
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROBERT WARD BURMAN M.D., PH.D.
Radiology (Diagnostic Radiology)
2045 N FRANKLIN ST
DENVER, CO 80205
Denver County (303) 338-4545
KIMBERLY ANN JOHNSON FNP-BC
Nurse Practitioner (Family)
2045 N FRANKLIN ST
DENVER, CO 80205
Denver County (303) 344-4545
MS. ABIGAIL M MCMAHON AUD
Audiologist
2045 N FRANKLIN ST
DENVER, CO 80205
Denver County (303) 338-4545
DR. JESUS HELIODORO HERMOSILLO RODRIGUEZ MD
Internal Medicine (Hematology & Oncology)
2045 N FRANKLIN ST
DENVER, CO 80205
Denver County (303) 338-4545
SUZANNE MARIE EHLER FNP
Nurse Practitioner (Family)
2045 N FRANKLIN ST
DENVER, CO 80205
Denver County (303) 338-4545
CENDI M DURAN RN
Registered Nurse
2045 N FRANKLIN ST
DENVER, CO 80205
Denver County (303) 764-4463
DR. PETER JOSEPH KLAUCK MD
Anesthesiology
2045 N FRANKLIN ST
DENVER, CO 80205
Denver County (303) 338-4545
MELANIE PHILLIPS
Registered Nurse (Oncology)
2045 N FRANKLIN ST
DENVER, CO 80205
Denver County (303) 338-4545

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Pettijohn's NPI number?

The NPI number for Kelly Pettijohn is 1023451176. It was assigned to this individual provider in the NPPES registry on April 8, 2013.

Where is Kelly Pettijohn located?

Kelly Pettijohn practices at 2045 N Franklin St, Denver, CO 80205. The listed phone number is (303) 338-4545.

What is Kelly Pettijohn's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Plastic Surgery within the Head & Neck, with taxonomy code 207YX0007X.

Is Kelly Pettijohn enrolled in Medicare?

Yes. Kelly Pettijohn is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kelly Pettijohn was last updated on March 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.