Healthcare Provider Details

I. General information

NPI: 1801873963
Provider Name (Legal Business Name): KATHLEEN REED FOOTE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15909 JACKSON CREEK PKWY
MONUMENT CO
80132-8693
US

IV. Provider business mailing address

PO BOX 96809
CHARLOTTE NC
28296-6809
US

V. Phone/Fax

Practice location:
  • Phone: 719-488-6998
  • Fax:
Mailing address:
  • Phone: 828-497-9163
  • Fax: 828-497-1723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2005-03684
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.0037997
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: