Provider Demographics
NPI:1700026051
Name:KNEPSHIELD, ROBERT SHANE (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:SHANE
Last Name:KNEPSHIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8080 PARK MEADOWS DR.
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80214-2558
Mailing Address - Country:US
Mailing Address - Phone:303-346-8828
Mailing Address - Fax:303-346-0407
Practice Address - Street 1:8080 PARK MEADOWS DR.
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-2558
Practice Address - Country:US
Practice Address - Phone:303-346-8828
Practice Address - Fax:303-346-0407
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO51341207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOA108783Medicaid