NPIMap

Organization Active NPI

Physio Pro, Inc.

Doing business as Evolution Physical Therapy

  • Physical Therapist
  • Golden, CO
National Provider Identifier
1104573666
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PHYSIO PRO, INC.
Doing business as
Evolution Physical Therapy
Practice address
393 Washington Ave Unit B
Golden, CO 80403-1889
Phone
(720) 307-7707
Fax
(720) 307-7702
NPI assigned
Mar 4, 2022
Last updated
Sep 10, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
PHYSIO PRO, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Authorized official

Name
Nathan J Lilley, PTNPI 1598833618
Title
Owner
Phone
(303) 370-2670

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

393 Washington Ave Unit B
Golden, CO 80403-1889

Mailing address

393 Washington Ave Unit B
Golden, CO 80403-1889
Phone (720) 307-7707

Other names 1

  • Evolution Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101117000278 CO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0941394753 Receives reassigned benefits from 30 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Golden, CO; Parker, CO; Denver, CO; Carbondale, CO

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Physio Pro Inc2 organizations share this tax ID, including this one
Part of
Physio Pro Inc

Other organizations with this tax ID 1

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

Locations

311 Steele St
Ste 200
Denver, CO 80206
Phone (303) 370-2670

3801 E Florida Ave
Ste 330
Denver, CO 80210
Phone (303) 370-2670

710 S Ash St
Ste 170
Denver, CO 80246
Phone (303) 370-2670

393 Washington Ave
Unit B
Golden, CO 80403
Phone (720) 307-7707

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 33

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.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1646352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757462400000",
    "number": "1104573666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 WASHINGTON AVE UNIT B",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804031889",
            "telephone_number": "720-307-7707",
            "fax_number": "720-307-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 WASHINGTON AVE UNIT B",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804031889",
            "telephone_number": "720-307-7707",
            "fax_number": "720-307-7702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIO PRO, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHYSIO PRO, INC.",
        "enumeration_date": "2022-03-04",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A",
        "authorized_official_last_name": "LILLEY",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-370-2670",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolution Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evolution Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Golden, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.