Active NPI
Connect Movement Center LLC
Doing business as Connect Movement Center
- Physical Therapist
- Fairplay, CO
National Provider Identifier
1114537438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- CONNECT MOVEMENT CENTER LLC
- Doing business as
- Connect Movement Center
- Practice address
- 540 Front Street
Fairplay, CO 80440 - Phone
- (630) 881-7866
- NPI assigned
- Aug 1, 2020
- Last updated
- May 15, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Connie Chen Bentivolio
- Title
- Owner
- Phone
- (719) 838-4083
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NU | Primary |
Addresses
Primary practice location
540 Front Street
Fairplay, CO 80440
Mailing address
PO Box 1945
Fairplay, CO 80440-1945
Phone (719) 293-5198
Other practice location 1
532A US Highway 285
Fairplay, CO 80440
Phone (719) 293-5198
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9000186967 | Medicaid | CO |
Other names 1
- Connect Movement Center
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596240000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1684108800000",
"number": "1114537438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1945",
"city": "FAIRPLAY",
"state": "CO",
"postal_code": "804401945",
"telephone_number": "719-293-5198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 FRONT STREET",
"city": "FAIRPLAY",
"state": "CO",
"postal_code": "80440",
"telephone_number": "630-881-7866"
}
],
"practiceLocations": [
{
"address_1": "532A US Highway 285",
"address_purpose": "LOCATION",
"city": "Fairplay",
"state": "CO",
"postal_code": "80440",
"country_code": "US",
"telephone_number": "719-293-5198",
"fax_number": "719-931-1319",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "CONNECT MOVEMENT CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-08-01",
"last_updated": "2023-05-15",
"certification_date": "2023-05-15",
"status": "A",
"authorized_official_last_name": "BENTIVOLIO",
"authorized_official_first_name": "CONNIE",
"authorized_official_middle_name": "CHEN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "719-838-4083"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9000186967",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Connect Movement Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Connect Movement Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fairplay, CO
- James E Caldwell, DDS
- Patricia L Chandler, PHD, MA, LPC, MAC
- Children's Trauma Center, LLC
- Conifer Counseling and Therapy Services, Inc
- Conifer Counseling and Therapy Services, Inc (Park County Counseling)
- County of Park Dba Park County Public Health
- Shirlene Davis, LMT
- Rebecka F Dinwoodie
- Diversus Health Inc (Diversus Health Services)
- Diversus Health Inc (AspenPointe Health Services)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.