NPIMap

Organization Active NPI

Cle Physical Therapy, PLLC

  • Physical Therapist
  • Edwards, CO
National Provider Identifier
1164087169
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CLE PHYSICAL THERAPY, PLLC
Practice address
56 Edwards Village Blvd Unit 204
Edwards, CO 81632-7804
Phone
(404) 593-5104
NPI assigned
May 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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

Authorized official

Name
Carrie Lee Eckenhoff
Title
Owner
Phone
(404) 593-5104

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

56 Edwards Village Blvd Unit 204
Edwards, CO 81632-7804

Mailing address

PO Box 3295
Avon, CO 81620-3295
Phone (404) 593-5104

Other practice location 1

2485 Old Trail Road B
Avon, CO 81620-3295
Phone (404) 593-5104

Other names 1

  • Equilibrium Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

56 Edwards Village Blvd
Unit 204
Edwards, CO 81632
Phone (404) 593-5104

NPI Registry JSON

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626393600000",
    "number": "1164087169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3295",
            "city": "AVON",
            "state": "CO",
            "postal_code": "816203295",
            "telephone_number": "404-593-5104",
            "fax_number": "970-965-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 EDWARDS VILLAGE BLVD UNIT 204",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816327804",
            "telephone_number": "404-593-5104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2485 Old Trail Road B",
            "address_purpose": "LOCATION",
            "city": "Avon",
            "state": "CO",
            "postal_code": "816203295",
            "country_code": "US",
            "telephone_number": "404-593-5104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CLE PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-06",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A",
        "authorized_official_last_name": "ECKENHOFF",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-593-5104"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Equilibrium Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Equilibrium Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edwards, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2021; 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.