Individual provider Active NPI

Kimberly Michelle Juge, PT

  • Physical Therapist
  • Longmont, CO
National Provider Identifier
1104844653
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9074 Issued in CO
Practice address
275 S Main Street
Suite 201
Longmont, CO 80501
Phone
(303) 682-2440
Fax
(303) 682-0229
NPI assigned
Jul 17, 2006
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 9074 CO Primary

Addresses

Primary practice location

275 S Main Street
Suite 201
Longmont, CO 80501

Mailing address

4790 Table Mesa Drive
Suite 200
Boulder, CO 80305
Phone (303) 447-2873

Other names 1

  • Kimberly Michelle Hardee Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9074COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascend Physical Therapy, Inc Physical Therapist PastSince May 1, 2015 Accepting new patients
Medically Based Fitness PC Past Accepting new patients
South Valley Physical Therapy PC PastSince Mar 26, 2023 Accepting new patients
Innovative Management Inc PastSince Jan 5, 2013 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104844653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4790 TABLE MESA DRIVE",
            "address_2": "SUITE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80305",
            "telephone_number": "303-447-2873",
            "fax_number": "303-447-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 S MAIN STREET",
            "address_2": "SUITE 201",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "80501",
            "telephone_number": "303-682-2440",
            "fax_number": "303-682-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUGE",
        "first_name": "KIMBERLY",
        "middle_name": "MICHELLE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "9074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "HARDEE",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.