KELLY BOSSOLA, PT — NPI 1811177322 (Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) in EDWARDS, CO)

CMS-1500 Box 24J / 33a • NPI

1811177322

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

2251P0200X (CMS 65)

Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)

Box 32 Service Location & ZIP+4

320 BEARD CREEK RD STE 1100, EDWARDS, CO, 81632-6433

✓ 9-Digit EDI 837 ZIP+4 (81632-6433)

Practice Phone & Referral Fax

(970) 569-7777

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1811177322 (KELLY BOSSOLA, PT) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1811177322` (NPI-1 Individual Practitioner)
Provider / Legal Name	KELLY BOSSOLA, PT
Plain-English Specialty	Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) NUCC Code: `2251P0200X` (Physical Therapist, Pediatrics)
Certifying / Licensing Body	American Board of Pediatrics (ABP)
Practice Location Address	320 BEARD CREEK RD STE 1100, EDWARDS, CO, 81632-6433
Practice Telephone / Fax	Tel: (970) 569-7777
Administrative Mailing Address	PO BOX 40000, VAIL, CO, 81658-7520
Enumeration & Last Sync	Enumerated: 2007-11-13 \| CMS Record Updated: 2025-11-03

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

320 BEARD CREEK RD STE 1100, EDWARDS, CO, 81632-6433

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Plain-English Taxonomy & CMS Crosswalk (2251P0200X)

What Does Taxonomy Code 2251P0200X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 2251P0200X translates to:
"Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 65 (Physical Therapist in Private Practice)
Certifying / Accrediting Authority: American Board of Pediatrics (ABP)
Clinical Scope: Newborn jaundice screening, routine childhood vaccinations, developmental milestones, pediatric fevers, ear infections, asthma, or acute gastroenteritis.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (KELLY BOSSOLA, PT)

Typical CPT / Diagnostic Procedures:

Comprehensive Well-Child Developmental & Growth Visits (CPT 99381–99394)
Childhood Immunization Administration (Rotavirus, MMR, DTaP, HPV, PCV)
Neonatal Bilirubin & Jaundice Transcutaneous/Serum Screening
Rapid Streptococcal, RSV & Influenza Point-of-Care Diagnostics
Pediatric Asthma Nebulization & Spirometry Evaluation

Common Therapeutic Classes:

Amoxicillin / Amoxicillin-Clavulanate (Pediatric Otitis Media & Sinusitis)
WHO Low-Osmolarity Oral Rehydration Salts (ORS) & Zinc Sulfate
Albuterol Sulfate Inhalers & Fluticasone Pediatric Inhalers
Weight-Based Acetaminophen & Ibuprofen Antipyretic Suspensions

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`225100000X` — Physical Therapist Plain English: Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist	State: PA \| License: `PT016522` \| Primary: Secondary
`2251P0200X` — Physical Therapist, Pediatrics Plain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)	State: PA \| License: `PT016522` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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KELLY BOSSOLA, PT (NPI #1811177322)