Organization Active NPI

North Boulder Physical Therapy Sports Rehabilitation LLC

  • Physical Therapist
  • Boulder, CO
National Provider Identifier
1124076583
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
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
Last updated
Mar 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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

Authorized official

Name
Ms. Debra Jan Layne, PTNPI 1588661334
Title
Owner, Managing Member
Phone
(303) 601-6666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1413 CO Primary
Hand Occupational Therapist 225XH1200X NOT APPLICABLE CO

Addresses

Primary practice location

3000 Center Green Dr
110
Boulder, CO 80301-2364

Mailing address

295 Broken Fence Rd
North Boulder Physical Therapy/Debra Layne
Boulder, CO 80302-9607
Phone (303) 601-6666

Other names 1

  • North Boulder Physical Therapy Other name

National Provider Directory

National Provider Directory

Locations

3000 Center Green Dr
Ste 110
Boulder, CO 80301
Phone (303) 413-9903

4865 Sterling Dr
Ste 201
Boulder, CO 80301

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "1413",
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_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"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

  • 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.