Active NPI
Krisanna Lin Chadwick, MSPT
- Physical Therapist
- Severance, CO
National Provider Identifier
1053532879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7190
- Practice address
- 5032 Prairie Lark LN
Severance, CO 80615-8105 - Phone
- (970) 405-3282
- NPI assigned
- May 1, 2007
- Last updated
- Jul 30, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 7190 | CO | |
| Physical Therapist | 225100000X | 7190 | CO | Primary |
Addresses
Primary practice location
5032 Prairie Lark LN
Severance, CO 80615-8105
Mailing address
5032 Prairie Lark LN
Severance, CO 80615-8105
Phone (970) 405-3282
Other practice location 1
6200 W 9th St
Suite 4B
Greeley, CO 80634-4462
Phone (970) 352-3622
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7190 | CO | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Krisanna Chadwick, Inc | Pediatrics | Current | Accepting new patients |
Organizations & group practices 1
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": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596067200000",
"number": "1053532879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5032 PRAIRIE LARK LN",
"city": "SEVERANCE",
"state": "CO",
"postal_code": "806158105",
"telephone_number": "970-405-3282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5032 PRAIRIE LARK LN",
"city": "SEVERANCE",
"state": "CO",
"postal_code": "806158105",
"telephone_number": "970-405-3282"
}
],
"practiceLocations": [
{
"address_1": "6200 W 9th St",
"address_2": "Suite 4B",
"address_purpose": "LOCATION",
"city": "Greeley",
"state": "CO",
"postal_code": "806344462",
"country_code": "US",
"telephone_number": "970-352-3622",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHADWICK",
"first_name": "KRISANNA",
"middle_name": "LIN",
"name_prefix": "Mrs.",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2020-07-30",
"certification_date": "2020-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "CO",
"license": "7190",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "7190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Severance, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.