MEDICARE: EKAGRA HEALTH INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246YR1600X	Registered Record Administrator

General Provider Information

NPI Number	:	1912834771
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EKAGRA HEALTH INC

Provider Business Mailing Address
First Line	:	4798 S ACOMA ST
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80110-6541
Country	:	US
Telephone Number	:	720-557-6510
Fax Number	:	303-432-2296

Provider Business Practice Location Address
First Line	:	4798 S ACOMA ST
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80110-6541
Country	:	US
Telephone Number	:	720-557-6510
Fax Number	:	303-432-2296

Authorized Official
Title or Position	:	FOUNDER
Name	:	DR. TRACI A KIMBALL
Credential	:	MD MBA
Telephone Number	:	720-557-6510

Provider Enumeration Date	:	05/06/2026
Last Update Date	:	05/06/2026

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