NPIMap

Organization Active NPI

Purpose Medical Professional Corporation

  • Orthopedic Physical Therapist
  • Denver, CO
National Provider Identifier
1164510038
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
5852 Issued in CO
Legal business name
PURPOSE MEDICAL PROFESSIONAL CORPORATION
Practice address
2828 W 44TH Ave
Denver, CO 80211-1429
Phone
(303) 477-5303
Fax
(303) 477-5302
NPI assigned
Oct 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Authorized official

Name
Mr. Rick Olderman, MSPT, CPT
Title
President
Phone
(303) 477-5303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X 5852 CO Primary

Addresses

Primary practice location

2828 W 44TH Ave
Denver, CO 80211-1429

Mailing address

2828 W 44TH Ave
Denver, CO 80211-1429
Phone (303) 477-5303

Other identifiers 1

IdentifierTypeStateIssuer
72435313MedicaidCO

Other names 1

  • Body In Balance Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

2828 W 44th Ave
Denver, CO 80211
Phone (303) 477-5303

3919 Tennyson St
Denver, CO 80212
Phone (303) 477-5303

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1164510038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 W 44TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802111429",
            "telephone_number": "303-477-5303",
            "fax_number": "303-477-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 W 44TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802111429",
            "telephone_number": "303-477-5303",
            "fax_number": "303-477-5302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURPOSE MEDICAL PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "OLDERMAN",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-477-5303",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT, CPT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CO",
            "license": "5852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "72435313",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Body In Balance Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Body In Balance Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

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