Active NPI
Jaclyn Marie Fitzpatrick, PT, DPT
- Physical Therapist
- Golden, CO
National Provider Identifier
1174062129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0014490
- Practice address
- 1020 Johnson Rd Ste 1400
Golden, CO 80401-6002 - Phone
- (720) 723-5079
- NPI assigned
- Feb 22, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 0014490 | CO | Primary |
Addresses
Primary practice location
1020 Johnson Rd Ste 1400
Golden, CO 80401-6002
Mailing address
1850 Larkspur Dr
Golden, CO 80401-9114
Phone (201) 341-0953
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0014490 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621814400000",
"number": "1174062129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1850 LARKSPUR DR",
"city": "GOLDEN",
"state": "CO",
"postal_code": "804019114",
"telephone_number": "201-341-0953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 JOHNSON RD STE 1400",
"city": "GOLDEN",
"state": "CO",
"postal_code": "804016002",
"telephone_number": "720-723-5079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZPATRICK",
"first_name": "JACLYN",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-22",
"last_updated": "2021-05-24",
"certification_date": "2021-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "0014490",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Golden, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.