NPIMap

Organization Active NPI

Developmental Pediatrics

  • Physical Therapist
  • Colorado Springs, CO
National Provider Identifier
1043340979
Registry record updated Dec 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
01101574 Issued in CO
Legal business name
DEVELOPMENTAL PEDIATRICS
Practice address
2210 Lelaray St
Colorado Springs, CO 80909
Phone
(719) 475-0477
Fax
(719) 475-1021
NPI assigned
Mar 7, 2007
Last updated
Dec 22, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2009

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

Authorized official

Name
Lily M Frasch, PTNPI 1861522187
Title
Pres
Phone
(719) 475-0477

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 01101574 CO Primary
Occupational Therapist 225X00000X 01101574 CO
Speech-Language Pathologist 235Z00000X 01101574 CO

Addresses

Primary practice location

2210 Lelaray St
Colorado Springs, CO 80909

Mailing address

2210 Lelaray St
Colorado Springs, CO 80909
Phone (719) 475-0477

Other identifiers 1

IdentifierTypeStateIssuer
07110158MedicaidCO

National Provider Directory

National Provider Directory

Locations

2210 Lelaray St
Colorado Springs, CO 80909
Phone (719) 475-0477

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261440000000",
    "number": "1043340979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 LELARAY ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80909",
            "telephone_number": "719-475-0477",
            "fax_number": "719-475-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 LELARAY ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80909",
            "telephone_number": "719-475-0477",
            "fax_number": "719-475-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENTAL PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2009-12-22",
        "status": "A",
        "authorized_official_last_name": "FRASCH",
        "authorized_official_first_name": "LILY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "719-475-0477",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "01101574",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "01101574",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "01101574",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07110158",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; 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.