NPIMap

Organization Active NPI

Crafted Physical Therapy PLLC

  • Physical Therapist
  • Longmont, CO
National Provider Identifier
1013404714
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CRAFTED PHYSICAL THERAPY PLLC
Practice address
701 Delaware Ave Unit E
Longmont, CO 80501
Phone
(720) 204-4567
NPI assigned
Apr 18, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Robert Rawlings IV, PT, DPT, COMT, OCSNPI 1588710362
Title
Managing Partner
Phone
(720) 204-4567

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

701 Delaware Ave Unit E
Longmont, CO 80501

Mailing address

701 Delaware Ave Unit E
Longmont, CO 80501-6498
Phone (720) 204-4567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180627000883 CO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3779839170 Receives reassigned benefits from 9 practitioners
Practice locations: Longmont, CO

National Provider Directory

National Provider Directory
Tax ID family
Crafted Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

701 Delaware Ave
Unit E
Longmont, CO 80501
Phone (303) 729-1447

Networks

  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1013404714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 DELAWARE AVE UNIT E",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016498",
            "telephone_number": "720-204-4567",
            "fax_number": "720-204-4568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DELAWARE AVE UNIT E",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "80501",
            "telephone_number": "720-204-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAFTED PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-18",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "RAWLINGS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "720-204-4567",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "PT, DPT, COMT, OCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.