Individual provider Active NPI

Eli Krug Edwards, PT, DPT

  • Physical Therapist
  • Denver, CO
National Provider Identifier
1053900662
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
17441 Issued in CO
Practice address
2101 S Platte River Dr Unit a
Denver, CO 80223-4015
Phone
(720) 248-4386
NPI assigned
Jan 18, 2021
Last updated
Oct 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 17441 CO Primary

Addresses

Primary practice location

2101 S Platte River Dr Unit a
Denver, CO 80223-4015

Mailing address

2101 S Platte River Dr Unit a
Denver, CO 80223-4015
Phone (720) 248-4386

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
17441COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rise Rehabilitation and Sport Performance PLLC CurrentSince Oct 20, 2024 Accepting new patients
Panorama Orthopedics & Spine Center, PC CurrentSince Feb 1, 2021 Accepting new patients
Panorama Orthopedics and Spine Center PC CurrentSince Feb 1, 2021 Accepting new patients

Locations

2101 S Platte River Dr
Unit A
Denver, CO 80223
Phone (720) 248-4386

660 Golden Ridge Rd
Ste 250
Golden, CO 80401
Phone (303) 274-7321

8510 Bryant St
Ste 130
Westminster, CO 80031
Phone (303) 428-4646

Organizations & group practices 3

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": "1610928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1053900662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 S PLATTE RIVER DR UNIT A",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802234015",
            "telephone_number": "720-248-4386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 S PLATTE RIVER DR UNIT A",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802234015",
            "telephone_number": "720-248-4386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ELI",
        "middle_name": "KRUG",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-18",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "17441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.