Individual provider Active NPI

Theresa Benjamin, DPT

  • Physical Therapist
  • Fort Collins, CO
National Provider Identifier
1083834196
Registry record updated Jun 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7779 Issued in CO
Practice address
2108 Midpoint Drive
Fort Collins, CO 80525
Phone
(970) 224-4141
Fax
(970) 797-1227
NPI assigned
Apr 30, 2007
Last updated
Jun 23, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2014

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 7779 CO Primary

Addresses

Primary practice location

2108 Midpoint Drive
Fort Collins, CO 80525

Mailing address

2108 Midpoint Drive
Fort Collins, CO 80525
Phone (970) 224-4141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150410000535 CO Practitioner - Physical Therapist in Private Practice 2163740747 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proactive Physical Therapy and Exercise Center, IncGroup PAC ID 8022190826, 6 clinicians

Practice addresses (Care Compare)

1024 Centre Ave
Suite 100
Fort Collins, CO 80526-1887
Phone (970) 224-4141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7779COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Adams & Giddings Physical Therapy, PC Physical Therapist CurrentSince Apr 3, 2015 Accepting new patients
Proactive Physical Therapy and Exercise Center, Inc Physical Therapist CurrentSince Apr 1, 2015 Accepting new patients

Locations

1024 Centre Ave
Ste 100
Fort Collins, CO 80526
Phone (970) 224-4141

2108 Midpoint Dr
Fort Collins, CO 80525
Phone (970) 224-4141

702 W Drake Rd
Bldg E-A
Fort Collins, CO 80526
Phone (970) 416-8342

702 W Drake Rd
Ste A
Fort Collins, CO 80526
Phone (970) 229-4600

Organizations & group practices 2

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": "1177891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1083834196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 MIDPOINT DRIVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "80525",
            "telephone_number": "970-224-4141",
            "fax_number": "970-797-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 MIDPOINT DRIVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "80525",
            "telephone_number": "970-224-4141",
            "fax_number": "970-797-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-30",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "7779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.