Individual provider Active NPI

Indira S Lanig, MD

  • Physical Medicine & Rehabilitation Physician
  • Johnstown, CO
National Provider Identifier
1124006119
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
DR0029314 Issued in CO
Practice address
4401 Union St
Northern Colorado Rehabilitation Hospital
Johnstown, CO 80534-2800
Phone
(303) 761-1215
Fax
(303) 762-1701
NPI assigned
Jan 9, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X G8233 TX
Physical Medicine & Rehabilitation Physician 208100000X DR0029314 CO Primary
Physical Medicine & Rehabilitation Physician 208100000X MD60610353 WA
Spinal Cord Injury Medicine Physician 2081P0004X DR0029314 CO

Addresses

Primary practice location

4401 Union St
Northern Colorado Rehabilitation Hospital
Johnstown, CO 80534-2800

Mailing address

6834 S University Blvd
#122
Centennial, CO 80122-1515
Phone (303) 761-1215

Other identifiers 3

IdentifierTypeStateIssuer
100261155-00MedicaidNE
1124006119MedicaidWY
01293141MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100304000176 CO Practitioner - Physical Medicine and RehabilitationPractitioner - Other (Physician) 5799820569 Practice locations: Johnstown, CO
I20180307000354 TX Practitioner - Physical Medicine and Rehabilitation 5799820569 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G8233TXMDPhysical Medicine & Rehabilitation Physician
DR0029314COMDSpinal Cord Injury Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vibra Physicians LLC CurrentSince Feb 28, 2018 Accepting new patients
CNS Medical Group, PC Physical Medicine & Rehabilitation Past Accepting new patients
Vibra Hospital of Lake Travis LLC Past Accepting new patients

Locations

4401 Union St
Loveland, CO 80534
Phone (970) 619-3400

7501 Wallace Blvd
Amarillo, TX 79124
Phone (806) 351-1600

1395 George Dieter Dr
El Paso, TX 79936
Phone (915) 298-7225

8081 Royal Ridge Pkwy
Ste 120
Irving, TX 75063

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124006119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6834 S UNIVERSITY BLVD",
            "address_2": "#122",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801221515",
            "telephone_number": "303-761-1215",
            "fax_number": "303-762-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 UNION ST",
            "address_2": "NORTHERN COLORADO REHABILITATION HOSPITAL",
            "city": "JOHNSTOWN",
            "state": "CO",
            "postal_code": "805342800",
            "telephone_number": "303-761-1215",
            "fax_number": "303-762-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANIG",
        "first_name": "INDIRA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "G8233",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CO",
            "license": "DR0029314",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "MD60610353",
            "primary": false
        },
        {
            "code": "2081P0004X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
            "state": "CO",
            "license": "DR0029314",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100261155-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124006119",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01293141",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, CO

Sources for this page

Verify at the official NPI Registry.