Active NPI
Eleanor Hickerson
- Physical Therapist
- Fort Collins, CO
National Provider Identifier
1154515534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9743
- Practice address
- 2620 E Prospect Rd
Suite 160
Fort Collins, CO 80525-9098 - Phone
- (970) 221-5811
- Fax
- (970) 221-5817
- NPI assigned
- Aug 29, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9743 | CO | Primary |
Addresses
Primary practice location
2620 E Prospect Rd
Suite 160
Fort Collins, CO 80525-9098
Mailing address
5080 Spectrum Dr
Suite 1200 W
Addison, TX 75001-4648
Phone (972) 725-6673
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9743 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188345600000",
"number": "1154515534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5080 SPECTRUM DR",
"address_2": "SUITE 1200 W",
"city": "ADDISON",
"state": "TX",
"postal_code": "750014648",
"telephone_number": "972-725-6673",
"fax_number": "214-775-4406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2620 E PROSPECT RD",
"address_2": "SUITE 160",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805259098",
"telephone_number": "970-221-5811",
"fax_number": "970-221-5817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKERSON",
"first_name": "ELEANOR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-29",
"last_updated": "2007-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "9743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.