NPIMap

Organization Active NPI

Mountain Desert Therapy, PC.

  • Physical Therapist
  • Northglenn, CO
National Provider Identifier
1164644795
Registry record updated Apr 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8516 Issued in CO
Legal business name
MOUNTAIN DESERT THERAPY, PC.
Practice address
11450 Melody Drive
C-101
Northglenn, CO 80234
Phone
(303) 345-4515
NPI assigned
May 3, 2007
Last updated
Apr 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2016

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

Authorized official

Name
Ms. Susan Lynn Duguid, PTNPI 1750502506
Title
Director
Phone
(303) 345-4515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8516 CO Primary

Addresses

Primary practice location

11450 Melody Drive
C-101
Northglenn, CO 80234

Mailing address

PO Box 350592
Westminster, CO 80035
Phone (303) 345-4515

Other identifiers 1

IdentifierTypeStateIssuer
02204827MedicaidCO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461283200000",
    "number": "1164644795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 350592",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "80035",
            "telephone_number": "303-345-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11450 MELODY DRIVE",
            "address_2": "C-101",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "80234",
            "telephone_number": "303-345-4515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN DESERT THERAPY, PC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2016-04-22",
        "status": "A",
        "authorized_official_last_name": "DUGUID",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "303-345-4515",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "8516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02204827",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northglenn, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2016; 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.