Active NPI
Dane M Farnworth, PT
- Physical Therapist
- Pueblo, CO
National Provider Identifier
1023093200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 6541
- Practice address
- 3525 Spaulding Ave
Pueblo, CO 81008-2208 - Phone
- (719) 542-4444
- Fax
- (719) 543-1990
- NPI assigned
- Dec 12, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 6541 | CO | Primary |
Addresses
Primary practice location
3525 Spaulding Ave
Pueblo, CO 81008-2208
Mailing address
PO Box 612260
San Jose, CA 95161-2260
Phone (877) 325-2776
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3525 E Spaulding Ave
Pueblo, CO 81008-2208
Phone (719) 542-4444
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6541 | CO | MD | Mental Health Counselor |
| PT 6541 | CO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pueblo Rehab & Orthopedic Therapy LLC | Physical Therapist | Current | Accepting new patients |
Locations
3525 E Spaulding Ave
Pueblo, CO 81008
Phone (719) 347-9309
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Pueblo, CO
- NPI 1245212711
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1023093200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 612260",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951612260",
"telephone_number": "877-325-2776",
"fax_number": "408-945-4011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3525 SPAULDING AVE",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810082208",
"telephone_number": "719-542-4444",
"fax_number": "719-543-1990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARNWORTH",
"first_name": "DANE",
"middle_name": "M",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-12",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "PT 6541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.