Individual provider Active NPI

Leslie Ann Watson, RPT

  • Physical Therapist
  • Castle Rock, CO
National Provider Identifier
1164541819
Registry record updated Jan 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2076 Issued in CO
Practice address
6213 Diamond Ridge Pkwy
Castle Rock, CO 80108-7519
Phone
(303) 810-5176
Fax
(303) 693-5828
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2076 CO Primary
Physical Therapist 225100000X 7606 NY

Addresses

Primary practice location

6213 Diamond Ridge Pkwy
Castle Rock, CO 80108-7519

Mailing address

6213 Diamond Ridge Pkwy
Castle Rock, CO 80108-7519
Phone (303) 810-5176

Other identifiers 1

IdentifierTypeStateIssuer
96933828MedicaidCO

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

LicenseStateTypeSpecialty
2076COMDPhysical Therapist
7606NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295827200000",
    "number": "1164541819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6213 DIAMOND RIDGE PKWY",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801087519",
            "telephone_number": "303-810-5176",
            "fax_number": "303-693-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6213 DIAMOND RIDGE PKWY",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801087519",
            "telephone_number": "303-810-5176",
            "fax_number": "303-693-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "LESLIE",
        "middle_name": "ANN",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2011-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "2076",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "7606",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "96933828",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; 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.