Cody James De la Mater, DPT

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PTL.0017265 Issued in CO

Practice address

406 Hyland Park Dr Ste F
Glenwood Springs, CO 81601-4270

Phone

(970) 945-0506

NPI assigned

Oct 29, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1134729916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 BIRCH CT",
            "city": "RIFLE",
            "state": "CO",
            "postal_code": "816502955",
            "telephone_number": "714-472-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 HYLAND PARK DR STE F",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014270",
            "telephone_number": "970-945-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA MATER",
        "first_name": "CODY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CO",
            "license": "PTL.0017265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danco Supportive Services Colorado Inc
• Lora Lea Davis, PHARM D
• Sarah Davis, NP
• Seth Davis
• DDS Vantage PLLC
• Mark E. Dearing, M.D.
• Tamara M. Degler, RN
• Alissa Dell, FNP-C
• Benjamin Demko, DC
• Denver Recovery Group LLC

• Physical Therapy Clinic/Center in Glenwood Springs, CO
• Providers in Glenwood Springs, CO by specialty
• Physical Therapy Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.