Michael Craig Mahan, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL.0018839 Issued in CO

Practice address

3000 Center Green Dr Ste 300
Boulder, CO 80301-2364

Phone

(303) 413-9903

Fax

(303) 413-9907

NPI assigned

Sep 28, 2017

Last updated

Jan 31, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, CO2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/7230/brand/1/csg/1/fhir/r4

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.

• Back to Action Physical Therapy

  dba Back to Action Physical Therapy, LLC

  • Physical Therapist
  • Lafayette, CO
  • NPI 1609941434
  Medicare reassignment NPD
• Benchmark Physical Therapy of Oregon LLC

  • Physical Therapist
  • Grants Pass, OR
  • NPI 1801257191
  Medicare reassignment NPD
• Therapeutic Associates Inc

  dba TAI Mt. Ashland Physical Therapy

  • Physical Therapist
  • Ashland, OR
  • NPI 1972589364
  Medicare reassignment NPD
• Benchmark Physical Therapy of Or, LLC

  • Physical Therapist
  • Ashland, OR
  • NPI 1366935702
  NPD
• Benchmark Physical Therapy of Or, LLC

  • Physical Therapist
  • Roseburg, OR
  • NPI 1427524388
  NPD
• Therapeutic Associates Inc

  • Physical Therapist
  • Oregon City, OR
  • NPI 1124370861
  NPD
• Therapeutic Associates Inc

  dba TAI - Rock Creek

  • Physical Therapist
  • Portland, OR
  • NPI 1144042649
  NPD
• Grapevine Womens Health and Gynecology, LLC

  • Gynecology Physician
  • Hillsboro, OR
  • NPI 1780021899
  NPD (past)
• PT Plus at Old Trail, LLC

  • Physical Therapist
  • Crozet, VA
  • NPI 1588005250
  NPD (past)
• Therapeutic Associates Inc

  dba TAI Cedar Hills Physical Therapy

  • Physical Therapist
  • Portland, OR
  • NPI 1700862000
  NPD (past)

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1063921476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5718",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599035718",
            "telephone_number": "406-756-0134",
            "fax_number": "406-756-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 CENTER GREEN DR STE 300",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012364",
            "telephone_number": "303-413-9903",
            "fax_number": "303-413-9907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAN",
        "first_name": "MICHAEL",
        "middle_name": "CRAIG",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-28",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "2305211550",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0018839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Kathleen Maffitt, LCSW
• Morgan Lynne Magill, BCBA
• Elsa Magnusson, RBT
• Palmer Mahal, MA, LPCC
• Bryan M Mahan, D.O.
• Elizabeth Ann Maher, LPC
• Fayiz Mahgoub, OD
• Barbara Mahler, BARBARA MAHLER O.M.
• Julia Anna Mahler
• Elizabeth Julia Mahon, PT

• Physical Therapist in Boulder, CO
• Providers in Boulder, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.