Organization Active NPI

Advantage Physical Therapy & Welness, P.C.

  • Physical Therapy Clinic/Center
  • Durango, CO
National Provider Identifier
1083342653
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ADVANTAGE PHYSICAL THERAPY & WELNESS, P.C.
Practice address
1305 Escalante Dr. # 203
Durango, CO 81303
Phone
(970) 403-8067
Fax
(970) 212-7321
NPI assigned
Aug 11, 2022
Last updated
Aug 11, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVANTAGE PHYSICAL THERAPY & WELLNESS ,P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Authorized official

Name
Michael Testa, MSPT, CSCSNPI 1942291141
Title
Owner/President
Phone
(970) 259-7829

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

1305 Escalante Dr. # 203
Durango, CO 81303

Mailing address

3600 Main Avenue Suite a
Durango, CO 81301-4082
Phone (970) 259-7829

Other identifiers 1

IdentifierTypeStateIssuer
9000190945MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Advantage Physical Therapy Wellness PC4 organizations share this tax ID, including this one
Part of
Advantage Physical Therapy Wellness PC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1660176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1083342653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 MAIN AVENUE SUITE A",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813014082",
            "telephone_number": "970-259-7829",
            "fax_number": "970-259-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 ESCALANTE DR. # 203",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "81303",
            "telephone_number": "970-403-8067",
            "fax_number": "970-212-7321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE PHYSICAL THERAPY & WELNESS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANTAGE PHYSICAL THERAPY & WELLNESS ,P.C.",
        "enumeration_date": "2022-08-11",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "TESTA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "970-259-7829",
        "authorized_official_credential": "MSPT, CSCS"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000190945",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

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