Individual provider Active NPI

Beth Ann Sun, PHYICAL THERAPIST

  • Neurology Physical Therapist
  • Centennial, CO
National Provider Identifier
1104904713
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology Physical TherapistTaxonomy code 2251N0400X
License
PTL0010675 Issued in CO
Practice address
16799 E Lake Ave
Centennial, CO 80016-3079
Phone
(720) 845-1976
Fax
(720) 845-1958
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 832 AK
Neurology Physical Therapist 2251N0400X PTL0010675 CO Primary

Addresses

Primary practice location

16799 E Lake Ave
Centennial, CO 80016-3079

Mailing address

900 Potomac St
Aurora, CO 80011-6716
Phone (303) 363-5150

Other practice location 1

900 Potomac St
Aurora, CO 80011-6716
Phone (303) 363-5150

Other names 1

  • Beth Ann Knight Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221228003106 CO Practitioner - Physical Therapist in Private Practice 8527039742 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brainwave Neuro Rehab Services, LLCGroup PAC ID 6305280868, 2 clinicians

Practice addresses (Care Compare)

12500 E Iliff Ave
Suite 300
Aurora, CO 80014-1268
Phone (303) 731-4620

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
832AKMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fit Physical Therapy CurrentSince Nov 28, 2022 Accepting new patients
Brainwave Neuro Rehab Services LLC Neurology CurrentSince Jun 25, 2024 Accepting new patients
Fit Physical Therapy Prof LLC CurrentSince Nov 28, 2022 Accepting new patients
Aline Alaska Chiropractic LLC PastSince Nov 1, 2020 Accepting new patients
A Joint Effort Physical Therapy Inc. Specialist PastSince Jul 1, 2000 Accepting new patients

Locations

6350 Eldridge St
Arvada, CO 80004
Phone (303) 409-2133

16799 E Lake Ave
Centennial, CO 80016
Phone (303) 409-2133

12500 E Iliff Ave
Ste 300
Denver, CO 80014
Phone (303) 730-4620

6612 S Ward St
Littleton, CO 80127
Phone (303) 409-2133

Organizations & group practices 5

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1104904713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 POTOMAC ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800116716",
            "telephone_number": "303-363-5150",
            "fax_number": "303-363-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16799 E LAKE AVE",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800163079",
            "telephone_number": "720-845-1976",
            "fax_number": "720-845-1958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Potomac St",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800116716",
            "country_code": "US",
            "telephone_number": "303-363-5150",
            "fax_number": "303-363-5201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUN",
        "first_name": "BETH",
        "middle_name": "ANN",
        "credential": "PHYICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AK",
            "license": "832",
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "CO",
            "license": "PTL0010675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETH",
            "last_name": "KNIGHT",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Dec 1, 2022; 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.