NPIMap

Organization Active NPI

Kidspot Physical Therapy LLC

Doing business as KidSPOT Pediatric Therapies

  • Pediatric Occupational Therapist
  • Louisville, CO
National Provider Identifier
1053573634
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Legal business name
KIDSPOT PHYSICAL THERAPY LLC
Doing business as
KidSPOT Pediatric Therapies
Practice address
165 McCaslin Blvd.
Suite B
Louisville, CO 80027
Phone
(303) 604-6441
Fax
(303) 957-1955
NPI assigned
Jun 25, 2008
Last updated
Jul 31, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Authorized official

Name
Jessica Fuentes, PT, DPTNPI 1437286234
Title
Founder, Owner, PT
Phone
(303) 604-6441

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
Pediatric Physical Therapist 2251P0200X NU
Pediatric Occupational Therapist 225XP0200X NU Primary
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

165 McCaslin Blvd.
Suite B
Louisville, CO 80027

Mailing address

165 McCaslin Blvd.
Suite B
Louisville, CO 80027
Phone (303) 604-6441

Other identifiers 1

IdentifierTypeStateIssuer
99978245MedicaidCO

Other names 1

  • KidSPOT Pediatric Therapies Doing business as

National Provider Directory

National Provider Directory

Locations

801 Main St
Ste 10
Louisville, CO 80027
Phone (303) 604-6441

165 S McCaslin Blvd
Ste B
Superior, CO 80027
Phone (303) 604-6441

Practitioners & affiliated clinicians

Practitioners 10

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": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596153600000",
    "number": "1053573634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 MCCASLIN BLVD.",
            "address_2": "SUITE B",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "80027",
            "telephone_number": "303-604-6441",
            "fax_number": "303-957-1955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 MCCASLIN BLVD.",
            "address_2": "SUITE B",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "80027",
            "telephone_number": "303-604-6441",
            "fax_number": "303-957-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDSPOT PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-25",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A",
        "authorized_official_last_name": "FUENTES",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "FOUNDER, OWNER, PT",
        "authorized_official_telephone_number": "303-604-6441",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "99978245",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KidSPOT Pediatric Therapies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.

Verify at the official NPI Registry.