Pine River Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PINE RIVER PHYSICAL THERAPY, LLC

Practice address

480 Wolverine Dr Ste 5
Bayfield, CO 81122-9653

Phone

(970) 884-2956

NPI assigned

Apr 17, 2015

Organization subpart

No

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

Authorized official

Name

Donald Mooney

Title

Office Manager

Phone

(970) 903-8895

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 4

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

• Paula F Mooney, MSPT

  • Physical Therapist
  • Bayfield, CO
  • NPI 1770852956
  Medicare reassignment Care Compare group NPD
• Margaret Harrell Schaffer, M.S.P.T.

  • Orthopedic Physical Therapist
  • Crested Butte, CO
  • NPI 1407121726
  Medicare reassignment Care Compare group NPD
• Craig Short, DPT

  • Physical Therapist
  • Bayfield, CO
  • NPI 1811645633
  Medicare reassignment NPD
• Kristi Wilkinson

  • Physical Therapist
  • Durango, CO
  • NPI 1053700484
  NPD

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

{
    "created_epoch": "1429228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589155200000",
    "number": "1174910145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 WOLVERINE DR STE 5",
            "city": "BAYFIELD",
            "state": "CO",
            "postal_code": "811229653",
            "telephone_number": "970-884-2956",
            "fax_number": "844-269-9483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 WOLVERINE DR STE 5",
            "city": "BAYFIELD",
            "state": "CO",
            "postal_code": "811229653",
            "telephone_number": "970-884-2956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE RIVER PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-17",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A",
        "authorized_official_last_name": "MOONEY",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "970-903-8895"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16780051",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary E O'Donnell, RPH
• Painted Sky Dental
• Pediatric Partners of the Southwest P.C.
• Pine River Chiropractic Inc
• Pine River Health Care, Inc.
• Austin Laura Presas
• Carly Pecoriello Prudic, FNP-BC
• Robert Quinlan, RMT
• Kathleen Quinton
• Pamela Rakes, CMT

• Physical Therapy Clinic/Center in Bayfield, CO
• Providers in Bayfield, 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 May 11, 2020; 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.