Individual provider Active NPI

Geane Herl Boado Valdez

  • Physical Therapist
  • Loveland, CO
National Provider Identifier
1124793880
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP030264T Issued in CO
Practice address
3880 Grant Ave Ste 100
Loveland, CO 80538-8433
Phone
(970) 663-7780
NPI assigned
Aug 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 28587 MD
Physical Therapist 225100000X CP026015T SC
Physical Therapist 225100000X CP030264T CO Primary

Addresses

Primary practice location

3880 Grant Ave Ste 100
Loveland, CO 80538-8433

Mailing address

3880 Grant Ave Ste 100
Loveland, CO 80538-8433

Other practice location 1

75 W Wesmark Blvd
Sumter, SC 29150-1955
Phone (803) 938-5395

Other practice location 2

2618 N Salisbury Blvd
Salisbury, MD 21801-2194
Phone (410) 324-7409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, SC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210910000518 MD Practitioner - Physical Therapist in Private Practice 4385040781 Reassigns benefits to 2 organizations
I20210910000581 DC Practitioner - Physical Therapist in Private Practice 4385040781 Reassigns benefits to 1 organization
I20231219003023 SC Practitioner - Physical Therapist in Private Practice 4385040781 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP030264TCOMDPhysical Therapist
28587MDMDPhysical Therapist
CP026015TSCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Physical Therapy and Sports Medicine, Inc. CurrentSince Dec 1, 2023 Accepting new patients
Maryland Sportscare & Rehab, LLC Physical Therapist CurrentSince Aug 23, 2021 Accepting new patients
Carolina Physical Therapy and Sports Medicine Limited Partnership Physical Therapist CurrentSince Jan 2, 2024 Accepting new patients
Sage Physical Therapy & Wellness LLC Physical Therapist CurrentSince Dec 1, 2022 Accepting new patients
Maryland Sportscare & Rehab LLC Physical Therapist CurrentSince Aug 23, 2021 Accepting new patients
Sports Physical Therapy of Towson, P.a. Physical Therapist PastSince Oct 1, 1994 Accepting new patients

Locations

9815 Main St
Ste 206
Damascus, MD 20872
Phone (301) 253-6761

141 Thomas Johnson Dr
Ste 180
Frederick, MD 21702
Phone (301) 620-7478

25 Main St
Ste A
Reisterstown, MD 21136
Phone (410) 833-8300

7801 York Rd
Ste 236
Towson, MD 21204
Phone (410) 583-0333

3536A Urbana Pike
Urbana, MD 21704
Phone (301) 874-9200

141 Atrium Way
Columbia, SC 29223
Phone (803) 788-8484

75 W Wesmark Blvd
Sumter, SC 29150
Phone (800) 456-5857

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1124793880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 GRANT AVE STE 100",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805388433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 GRANT AVE STE 100",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805388433",
            "telephone_number": "970-663-7780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 W Wesmark Blvd",
            "address_purpose": "LOCATION",
            "city": "Sumter",
            "state": "SC",
            "postal_code": "291501955",
            "country_code": "US",
            "telephone_number": "803-938-5395",
            "fax_number": "803-938-5396",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2618 N Salisbury Blvd",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218012194",
            "country_code": "US",
            "telephone_number": "410-324-7409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALDEZ",
        "first_name": "GEANE HERL",
        "middle_name": "BOADO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-13",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "28587",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "CP026015T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "CP030264T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.