Individual provider Active NPI

Lori Benisch Snow, PT, MS, OCS

  • Physical Therapist
  • Boulder, CO
National Provider Identifier
1043262728
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8691 Issued in CO
Practice address
3000 Center Green Dr Ste 110
Boulder, CO 80301-2364
Phone
(303) 413-9903
Fax
(303) 413-9907
NPI assigned
May 17, 2006
Last updated
Dec 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8691 CO Primary

Addresses

Primary practice location

3000 Center Green Dr Ste 110
Boulder, CO 80301-2364

Mailing address

PO Box 5718
Kalispell, MT 59903-5718
Phone (406) 756-0134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051115000726 CO Practitioner - Physical Therapist in Private Practice 4486673894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Broomfield, CO 80021
Phone (720) 807-4461

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

8550 W 38TH Ave
100 Wheat Ridge Clinic Occupational Medicin
Wheat Ridge, CO 80033-1724
Phone (303) 467-4100

8550 W 38TH Ave
100 Wheat Ridge Clinic Physical Therapy
Wheat Ridge, CO 80033-4341
Phone (303) 467-4121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
8691COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Feb 10, 2020 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Feb 10, 2020 Accepting new patients

Locations

12169 Sheridan Blvd
Broomfield, CO 80020
Phone (303) 439-0169

2807 Roslyn St
Denver, CO 80238
Phone (303) 403-6333

16570 Washington St
Thornton, CO 80023
Phone (303) 689-6600

8550 W 38th Ave
Ste 100
Wheat Ridge, CO 80033
Phone (303) 467-4100

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1043262728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5718",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599035718",
            "telephone_number": "406-756-0134",
            "fax_number": "406-300-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 CENTER GREEN DR STE 110",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012364",
            "telephone_number": "303-413-9903",
            "fax_number": "303-413-9907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNOW",
        "first_name": "LORI",
        "middle_name": "BENISCH",
        "credential": "PT, MS, OCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "8691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.

Verify at the official NPI Registry.