Individual provider Active NPI

David Thomas Conlin, DPT

  • Physical Therapist
  • Woodland Park, CO
National Provider Identifier
1104168335
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL9247 Issued in CO
Practice address
41 State Highway 67
Woodland Park, CO 80863-5008
Phone
(719) 686-0553
Fax
(719) 687-5374
NPI assigned
Mar 26, 2013
Last updated
Feb 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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 PTL9247 CO Primary

Addresses

Primary practice location

41 State Highway 67
Woodland Park, CO 80863-5008

Mailing address

PO Box 801172
Kansas City, MO 64180-1172
Phone (800) 953-0104

Other practice location 1

112 W Spencer Ave
Suite C
Gunnison, CO 81230-2545
Phone (970) 641-2266

Other practice location 2

155 Printers Pkwy Ste 125
Colorado Springs, CO 80910-6102
Phone (719) 635-8622

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240219000728 CO Practitioner - Physical Therapist in Private Practice 0749624765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centura Ventures, LLCGroup PAC ID 8628989043, 30 clinicians

Practice addresses (Care Compare)

41 N Hwy 67 C
Colorado Sports and Spine Centers
Woodland Park, CO 80863-5009
Phone (719) 686-0553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL9247COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Centura Ventures, LLC Physical Therapist Current Accepting new patients
Centura Ventures, LLC CurrentSince Feb 19, 2024 Accepting new patients
Centura Ventures, LLC CurrentSince Feb 19, 2024 Accepting new patients
Revolution Rehabilitation P. C. PastSince Feb 1, 2007 Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

11960 Lioness Way
Ste 150
Parker, CO 80134
Phone (303) 269-2893

4112 Outlook Blvd
Ste 96
Pueblo, CO 81008
Phone (719) 562-6200

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

41 State Highway 67
Unit C
Woodland Park, CO 80863
Phone (719) 686-0553

Organizations & group practices 4

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": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1104168335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801172",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801172",
            "telephone_number": "800-953-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 STATE HIGHWAY 67",
            "city": "WOODLAND PARK",
            "state": "CO",
            "postal_code": "808635008",
            "telephone_number": "719-686-0553",
            "fax_number": "719-687-5374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 W Spencer Ave",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "Gunnison",
            "state": "CO",
            "postal_code": "812302545",
            "country_code": "US",
            "telephone_number": "970-641-2266",
            "fax_number": "970-641-0334",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "155 Printers Pkwy Ste 125",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809106102",
            "country_code": "US",
            "telephone_number": "719-635-8622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONLIN",
        "first_name": "DAVID",
        "middle_name": "THOMAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-26",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL9247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Park, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.