Agile Rehabilitation Services, LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

AGILE REHABILITATION SERVICES, LLC

Practice address

415 N Greenwood St Ste E
Pueblo, CO 81003-3173

Phone

(719) 542-1313

Fax

(719) 542-9140

NPI assigned

Jul 11, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Eric Neufeld, CPO

Title

Owner

Phone

(719) 542-1313

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Todd Bush

  • Prosthetist
  • Pueblo, CO
  • NPI 1144829219
  NPD
• Elizabeth Bush, CPO

  • Orthotist
  • Richmond, VA
  • NPI 1366041428
  NPD (past)

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1053045658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N GREENWOOD ST STE E",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033173",
            "telephone_number": "719-542-1313",
            "fax_number": "719-542-9140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N GREENWOOD ST STE E",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033173",
            "telephone_number": "719-542-1313",
            "fax_number": "719-542-9140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGILE REHABILITATION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-11",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A",
        "authorized_official_last_name": "NEUFELD",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-542-1313",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF COLORADO COMPANY ID#",
            "identifier": "20221667860",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Pueblo, CO
• Rehabilitation Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.