Organization Active NPI

Cary Gold Physical Therapy Inc

  • Physical Therapist
  • Boulder, CO
National Provider Identifier
1174642433
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3341 Issued in CO
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

Updated by the provider on May 7, 2008

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)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
GO22653OtherCOBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070829000918 CO Part B Supplier - Clinic/Group Practice 7618060179 Receives reassigned benefits from 1 practitioner
Practice locations: Boulder, CO

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.

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.

Verify at the official NPI Registry.