Individual provider Active NPI

Madison Katherine Gribben

  • Physical Therapy Assistant
  • Longmont, CO
National Provider Identifier
1013674795
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
0015087 Issued in CO
Practice address
805 Summer Hawk Dr Unit HH49
Longmont, CO 80504-8810
Phone
(262) 716-7178
NPI assigned
Nov 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 0015087 CO Primary

Addresses

Primary practice location

805 Summer Hawk Dr Unit HH49
Longmont, CO 80504-8810

Mailing address

805 Summer Hawk Dr Unit HH49
Longmont, CO 80504-8810
Phone (262) 716-7178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0015087COMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1013674795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SUMMER HAWK DR UNIT HH49",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805048810",
            "telephone_number": "262-716-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 SUMMER HAWK DR UNIT HH49",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805048810",
            "telephone_number": "262-716-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIBBEN",
        "first_name": "MADISON",
        "middle_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "0015087",
            "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 Nov 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.