Kelly Duda

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7742 Issued in CO

Practice address

5350 Manhattan Cir Ste 100
Boulder, CO 80303-4272

Phone

(303) 543-1201

Fax

(303) 543-1206

NPI assigned

Jul 11, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Centura Ventures, LLC

  dba CS Briargate at Sister

  • Physical Therapy Clinic/Center
  • Colorado Springs, CO
  • NPI 1073882197

  Physical Therapist

  NPD

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1033117320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 MANHATTAN CIR STE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034272",
            "telephone_number": "303-543-1201",
            "fax_number": "303-543-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 MANHATTAN CIR STE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034272",
            "telephone_number": "303-543-1201",
            "fax_number": "303-543-1206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7233 Church Ranch Blvd",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "CO",
            "postal_code": "800214094",
            "country_code": "US",
            "telephone_number": "303-925-4137",
            "fax_number": "303-925-4143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUDA",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-11",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "7742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "7742",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• DTG II PLLC (BeyondMD)
• Clarissa Monet Dubose
• Elena Dubose
• Sherry Renee Dubuisson, NURSE PRACTITIONER
• Betsy Duckett
• Karin Dudek, MA
• Braxton Massey Dudley Jr.
• Marilyn R Duey
• Alexander Duff, DC
• Benjamen Duffy

• Physical Therapist in Boulder, CO
• Providers in Boulder, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; 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.