Individual provider Active NPI

Jaimy Catherine Wahab, DPT

  • Physical Therapist
  • Centennial, CO
National Provider Identifier
1093868176
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8313 Issued in CO
Practice address
7120 E Orchard Rd
Suite 110
Centennial, CO 80111-1731
Phone
(303) 850-7717
NPI assigned
Jan 19, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 8313 CO Primary

Addresses

Primary practice location

7120 E Orchard Rd
Suite 110
Centennial, CO 80111-1731

Mailing address

7120 E Orchard Rd
Suite 110
Centennial, CO 80111-1731
Phone (303) 850-7717

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040412000635 CO Practitioner - Physical Therapist in Private Practice 3678567864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5387 Manhattan Cir
Suite 100a
Boulder, CO 80303-4283
Phone (303) 929-2950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8313COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Balance and Neurologic Center of the Rockies LLC Physical Therapist CurrentSince Jan 15, 2015 Accepting new patients

Locations

5387 Manhattan Cir
Ste 100A
Boulder, CO 80303
Phone (303) 499-6818

Interoperability endpoints

  • Direct secure messaging: jaimy.wahab.1@10587.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/10587/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093868176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7120 E ORCHARD RD",
            "address_2": "SUITE 110",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801111731",
            "telephone_number": "303-850-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7120 E ORCHARD RD",
            "address_2": "SUITE 110",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801111731",
            "telephone_number": "303-850-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHAB",
        "first_name": "JAIMY",
        "middle_name": "CATHERINE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "8313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.