Berthoud Physical Therapy LLC

Key facts

NPI: 1033315809
Entity type: Organization (NPI type 2)
Primary specialty: Physical Therapy Clinic/Center 261QP2000X
License: 6456 (CO)
Legal business name: BERTHOUD PHYSICAL THERAPY LLC
Practice address: 516 Mountain Ave
Berthoud, CO 80513
Phone: (970) 532-7500
Fax: (970) 532-7510
NPI assigned: Jun 26, 2007
Organization subpart: No

Authorized official

Name: Kelly Murtagh NPI 1104973387
Title: Owner
Phone: (970) 532-7500

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

Corporate family (same tax ID) 1

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

Berthoud Physical Therapy LLC Physical Therapist · Berthoud, CO · NPI 1962828384

NPD tax ID

Practitioners 1

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

Kelly K. Murtagh, MSPT Physical Therapist · Berthoud, CO · NPI 1104973387

Medicare reassignment NPD Authorized official CO · PHYSICAL THERAPIST

Medicare participation

Medicare fee-for-service enrollment: Enrolled in CO

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20170706001302	CO	Part B Supplier - Physical/Occupational Therapy Group in Private Practice	6305115346	Receives reassigned benefits from 1 practitioner Practice locations: Berthoud, CO

National Provider Directory

Tax ID family: Berthoud Physical Therapy (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapy Clinic/Center	261QP2000X	6456	CO	Yes

Addresses

Primary practice location

516 Mountain Ave
Berthoud, CO 80513

Mailing address

PO Box 1848
Berthoud, CO 80513-1848
Phone (970) 532-7500

Other providers in Berthoud, CO

All providers in Berthoud, CO · Physical Therapy Clinic/Center in Colorado

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.