Active NPI
Cary Gold Physical Therapy Inc
- Physical Therapist
- Boulder, CO
National Provider Identifier
1174642433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3341
- Legal business name
- CARY GOLD PHYSICAL THERAPY INC
- Practice address
- 5377 Manhattan Cir
Suite 102
Boulder, CO 80303-4333 - Phone
- (303) 449-7611
- Fax
- (303) 442-8786
- NPI assigned
- Mar 28, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Heather Terns
- Title
- Office Manager
- Phone
- (303) 449-7611
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3341 | CO | Primary |
Addresses
Primary practice location
5377 Manhattan Cir
Suite 102
Boulder, CO 80303-4333
Mailing address
5377 Manhattan Cir
Suite 102
Boulder, CO 80303-4333
Phone (303) 449-7611
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GO22653 | Other | CO | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Therapist
- Boulder, CO
- NPI 1295717916
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1210118400000",
"number": "1174642433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5377 MANHATTAN CIR",
"address_2": "SUITE 102",
"city": "BOULDER",
"state": "CO",
"postal_code": "803034333",
"telephone_number": "303-449-7611",
"fax_number": "303-442-8786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5377 MANHATTAN CIR",
"address_2": "SUITE 102",
"city": "BOULDER",
"state": "CO",
"postal_code": "803034333",
"telephone_number": "303-449-7611",
"fax_number": "303-442-8786"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CARY GOLD PHYSICAL THERAPY INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-28",
"last_updated": "2008-05-07",
"status": "A",
"authorized_official_last_name": "TERNS",
"authorized_official_first_name": "HEATHER",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "303-449-7611"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "CO",
"license": "3341",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "GO22653",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; 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.