Individual provider Active NPI

Chelsey Creedon, DPT

  • Physical Therapist
  • Longmont, CO
National Provider Identifier
1093197584
Registry record updated Jun 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0013306 Issued in CO
Practice address
275 S Main St Ste 208
Longmont, CO 80501-6461
Phone
(303) 776-3800
NPI assigned
Jun 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2015

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 0013306 CO Primary

Addresses

Primary practice location

275 S Main St Ste 208
Longmont, CO 80501-6461

Mailing address

275 S Main St Ste 208
Longmont, CO 80501-6461

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150716001457 CO Practitioner - Physical Therapist in Private Practice 1951614114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Altitude Physical Therapy and Sports Medicine LLCGroup PAC ID 8628050267, 18 clinicians

Practice addresses (Care Compare)

275 S Main St
Suite 200
Longmont, CO 80501-6461
Phone (303) 776-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0013306COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Altitude Physical Therapy & Sports Medicine LLC CurrentSince Jan 24, 2021 Accepting new patients
Altitude Physical Therapy & Sports Medicine LLC Physical Therapist CurrentSince May 29, 2015 Accepting new patients

Locations

275 S Main St
Ste 208
Longmont, CO 80501
Phone (303) 776-3800

275 S Main St
Ste 200
Longmont, CO 80501

7833 W 38th Ave
Wheat Ridge, CO 80033
Phone (303) 425-6534

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1093197584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 S MAIN ST STE 208",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 S MAIN ST STE 208",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016461",
            "telephone_number": "303-776-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREEDON",
        "first_name": "CHELSEY",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-22",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0013306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; 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.