Annie Kim Detweiler, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0017305 Issued in CO

Practice address

7878 Wadsworth Blvd Ste 210
Arvada, CO 80003-2121

Phone

(303) 456-8967

NPI assigned

Oct 15, 2020

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

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.

• Foothills Sports Medicine & Rehabilitation, LLC

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1073224267
  NPD
• Foothills Sports Medicine & Rehabilitation, LLC

  • Physical Therapist
  • Phoenix, AZ
  • NPI 1558318170
  NPD
• Foothills Sports Medicine & Rehabilitation, LLC

  • Physical Therapist
  • Tucson, AZ
  • NPI 1699405050
  NPD

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1033717525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2448 WELTON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052908",
            "telephone_number": "319-899-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7878 WADSWORTH BLVD STE 210",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800032121",
            "telephone_number": "303-456-8967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETWEILER",
        "first_name": "ANNIE",
        "middle_name": "KIM",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-15",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0017305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tobias M. Derloshon, D.D.S.
• Kerry Anne Derrick, M.A. LMFT
• Lindsey Derus, LPC
• Jil Kristine Dery, D.D.S.
• Deshano Care Centers LLC
• Developmental Disabilities Resource Center
• Developmental Disabilities Resource Center
• Developmental Disabilities Resource Center
• Thomas James Devine, M.ED
• Sarah Nicole Devlin, FNP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.