Mark L. Archambault, PT, PHD

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL0016304 Issued in CO

Practice address

3854 Village Seven Rd
Colorado Springs, CO 80917-2801

Phone

(719) 574-8761

Fax

(719) 574-8236

NPI assigned

Sep 13, 2006

Last updated

Dec 10, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Action Potential RLLPGroup PAC ID 7719976703, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Action Potential RLLP

  dba Action Potential

  • Physical Therapist
  • Colorado Springs, CO
  • NPI 1699939850
  Medicare reassignment Care Compare group NPD
• Action Potential RLLP

  • Multi-Specialty Clinic/Center
  • Colorado Springs, CO
  • NPI 1265274948

  Physical Therapist

  NPD
• Action Potential RLLP

  dba Action Potential

  • Physical Therapist
  • Colorado Springs, CO
  • NPI 1619914314
  NPD
• Action Potential RLLP

  dba Action Potential

  • Physical Therapist
  • Colorado Springs, CO
  • NPI 1013961770
  NPD (past)
• Action Potential RLLP

  dba Advanced Hand and Orthopedic Rehabilitation

  • Physical Therapist
  • Colorado Springs, CO
  • NPI 1093736316
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1174628333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5718",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599035718",
            "telephone_number": "406-756-0134",
            "fax_number": "406-309-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3854 VILLAGE SEVEN RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809172801",
            "telephone_number": "719-574-8761",
            "fax_number": "719-574-8236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHAMBAULT",
        "first_name": "MARK",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "PT, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL0016304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.