North Boulder Physical Therapy Sports Rehabilitation LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1413 Issued in CO

Legal business name

NORTH BOULDER PHYSICAL THERAPY SPORTS REHABILITATION LLC

Practice address

3000 Center Green Dr
110
Boulder, CO 80301-2364

Phone

(303) 413-9903

Fax

(303) 413-9907

NPI assigned

May 5, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Debra Jan Layne, PT

Title

Owner, Managing Member

Phone

(303) 601-6666

Specialties & licenses 2

Addresses

Other names 1

• North Boulder Physical Therapy Other name

Locations

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456790400000",
    "number": "1124076583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 BROKEN FENCE RD",
            "address_2": "NORTH BOULDER PHYSICAL THERAPY/DEBRA LAYNE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803029607",
            "telephone_number": "303-601-6666",
            "fax_number": "303-447-3390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 CENTER GREEN DR",
            "address_2": "110",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012364",
            "telephone_number": "303-413-9903",
            "fax_number": "303-413-9907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BOULDER PHYSICAL THERAPY SPORTS REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2016-03-01",
        "status": "A",
        "authorized_official_last_name": "LAYNE",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "JAN",
        "authorized_official_title_or_position": "OWNER, MANAGING MEMBER",
        "authorized_official_telephone_number": "303-601-6666",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "1413",
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": "CO",
            "license": "NOT APPLICABLE",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Boulder Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Physical Therapist in Boulder, CO
• Providers in Boulder, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.