Organization Active NPI

Colorado Sports Physical Therapy, LLC

  • Sports Physical Therapist
  • Lafayette, CO
National Provider Identifier
1043700594
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
License
0015257 Issued in CO
Legal business name
COLORADO SPORTS PHYSICAL THERAPY, LLC
Practice address
390 Empire Rd Ste 201
Lafayette, CO 80026-2606
Phone
(410) 279-0479
NPI assigned
May 10, 2018
Last updated
Feb 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Authorized official

Name
Catherine Schnell Campbell, PT, DPT, SCSNPI 1770890543
Title
Owner
Phone
(720) 216-5128

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251S0007X 0015257 CO Primary

Addresses

Primary practice location

390 Empire Rd Ste 201
Lafayette, CO 80026-2606

Mailing address

390 Empire Rd Ste 201
Lafayette, CO 80026-2606
Phone (720) 216-5128

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180718000666 CO Part B Supplier - Clinic/Group Practice 8527315829 Receives reassigned benefits from 1 practitioner
Practice locations: Lafayette, CO

National Provider Directory

National Provider Directory

Locations

390 Empire Rd
Ste 201
Lafayette, CO 80026
Phone (720) 216-5128

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581465600000",
    "number": "1043700594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 EMPIRE RD STE 201",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262606",
            "telephone_number": "720-216-5128",
            "fax_number": "720-316-6744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 EMPIRE RD STE 201",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262606",
            "telephone_number": "410-279-0479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO SPORTS PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-10",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "SCHNELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-216-5128",
        "authorized_official_credential": "PT, DPT, SCS"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "CO",
            "license": "0015257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare 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.