Active NPI
Penny Trevithick, CBS
- Specialist
- Longmont, CO
National Provider Identifier
1124357082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 5095BF
- Practice address
- 8380 Hygiene Rd
Longmont, CO 80503 - Phone
- (303) 579-7003
- NPI assigned
- Dec 23, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 5095BF | NC | Primary |
Addresses
Primary practice location
8380 Hygiene Rd
Longmont, CO 80503
Mailing address
P.O. Box 145
Hygiene, CO 80533
Phone (303) 579-7003
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5095BC | Other | NATIONAL THERAPIES CERTICICATION BOARD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5095BF | NC | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1261526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261526400000",
"number": "1124357082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 145",
"city": "HYGIENE",
"state": "CO",
"postal_code": "80533",
"telephone_number": "303-579-7003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8380 HYGIENE RD",
"city": "LONGMONT",
"state": "CO",
"postal_code": "80503",
"telephone_number": "303-579-7003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TREVITHICK",
"first_name": "PENNY",
"credential": "CBS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-12-23",
"last_updated": "2009-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NC",
"license": "5095BF",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL THERAPIES CERTICICATION BOARD",
"identifier": "5095BC",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Longmont, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.