Active NPI
Wyatt A Machupa, DPT
- Neurology Physical Therapist
- Colorado Springs, CO
National Provider Identifier
1164074852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physical Therapist
- License
- 0016393
- Practice address
- 202 E Cheyenne Mountain Blvd
Colorado Springs, CO 80906-3769 - Phone
- (719) 527-9331
- NPI assigned
- Jul 12, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 0016393 | CO | |
| Neurology Physical Therapist | 2251N0400X | 0016393 | CO | Primary |
Addresses
Primary practice location
202 E Cheyenne Mountain Blvd
Colorado Springs, CO 80906-3769
Mailing address
202 E Cheyenne Mountain Blvd
Colorado Springs, CO 80906-3769
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 |
|---|---|---|---|
| 0016393 | CO | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562889600000",
"number": "1164074852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 E CHEYENNE MOUNTAIN BLVD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809063769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 E CHEYENNE MOUNTAIN BLVD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809063769",
"telephone_number": "719-527-9331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACHUPA",
"first_name": "WYATT",
"middle_name": "A",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-12",
"last_updated": "2019-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CO",
"license": "0016393",
"primary": false
},
{
"code": "2251N0400X",
"taxonomy_group": "",
"desc": "Physical Therapist, Neurology",
"state": "CO",
"license": "0016393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.