Axis Sports Medicine, LLC
Organization Active NPI Physical Therapist · Silverthorne, CO
NPI 1104581438 · NPPES record last updated Mar 8, 2024
Key facts
- NPI
- 1104581438
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- AXIS SPORTS MEDICINE, LLC
- Practice address
- 1281 Blue River Parkway
Unit a
Silverthorne, CO 80498 - Phone
- (970) 368-6054
- Fax
- (970) 368-6919
- NPI assigned
- Nov 2, 2021
- Organization subpart
- No
Authorized official
- Name
- Amy Freeman
- Title
- Practice Manager
- Phone
- (541) 728-6531
Other NPIs on the same Medicare enrollment 5
Corporate family (same tax ID) 4
Practitioners 4
-
Carli Jane Berghoff, DPT
-
Eric Pearson, PT, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121107000390 | CO | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 7214188895 |
Receives reassigned benefits from 24 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Avon, CO; Silverthorne, CO; Frisco, CO; Breckenridge, CO; Eagle, CO |
National Provider Directory
- Tax ID family
- Axis Sports Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician |
208100000X | |||
| Physical Therapist |
225100000X | Yes |
Addresses
Primary practice location
1281 Blue River Parkway
Unit a
Silverthorne, CO 80498
Mailing address
PO Box 5584
Frisco, CO 80443-5584
Phone (970) 368-6054
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31155171 | Medicaid | CO |
Other names
- Axis Sports Medicine
Other providers in Silverthorne, CO
- Adapthealth West, LLC
- Aerocare Holdings, Inc.
- Altitude Neuromonitoring, LLC
- Paula M. Ashbaugh
- Hugo Ayala
- Backcountry Family Dental, PC
- Dana I Barnett
- Carli Jane Berghoff
- Christina Lynn Black
All providers in Silverthorne, CO · Physical Therapist in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.