Physical Therapy Connections, PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

5835 Issued in CO

Legal business name

PHYSICAL THERAPY CONNECTIONS, PC

Practice address

58 Glen Royal Dr
Pueblo, CO 81005-2174

Phone

(719) 565-6678

Fax

(719) 561-0577

NPI assigned

Mar 29, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Chad A. Clark, MSPT, CSCSNPI 1083617906

Title

Physical Therapist, Owner

Phone

(719) 565-6678

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 4

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

• Chad Alan Clark, MSPT

  • Physical Therapist
  • Pueblo, CO
  • NPI 1083617906
  Medicare reassignment Care Compare group NPD Authorized official
• Stephanie Nolting, DPT

  • Orthopedic Physical Therapist
  • Pueblo, CO
  • NPI 1407165913
  Medicare reassignment Care Compare group NPD
• Brandon Wiley, DPT

  • Physical Medicine & Rehabilitation Physician
  • Pueblo, CO
  • NPI 1093320111
  Medicare reassignment Care Compare group NPD
• Nicole Laureano, LMT

  • Massage Therapist
  • Pueblo, CO
  • NPI 1568976835
  NPD (past)

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1174642045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 GLEN ROYAL DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810052263",
            "telephone_number": "719-565-6678",
            "fax_number": "719-561-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 GLEN ROYAL DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810052174",
            "telephone_number": "719-565-6678",
            "fax_number": "719-561-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY CONNECTIONS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST, OWNER",
        "authorized_official_telephone_number": "719-565-6678",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT, CSCS"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CO",
            "license": "5835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36630233",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Phillips
• Kristie Phillips
• Marisa K Phillips, NP
• Misty Marie Phillips, RN
• Greg Allen Philson, DDS
• Physical, Rehabilitative and Occupational Medicine Center LLC
• Physician Anesthesia of Pueblo, PC
• Physician'S Choice Medical, LLC
• Jo Piano
• Taryn Pickerel, RN

• Physical Therapy Clinic/Center in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Physical Therapy Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.