Individual provider Active NPI

Jordan Winters

  • Physical Therapist
  • Parker, CO
National Provider Identifier
1194318105
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0017531 Issued in CO
Practice address
12311 Pine Bluffs Way Unit 112
Parker, CO 80134-7402
Phone
(239) 239-8348
NPI assigned
Feb 19, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL.0017531 CO Primary

Addresses

Primary practice location

12311 Pine Bluffs Way Unit 112
Parker, CO 80134-7402

Mailing address

1708 McGregor Reserve Dr
Fort Myers, FL 33901-9661
Phone (239) 834-8590

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210401001431 CO Practitioner - Physical Therapist in Private Practice 9032526363 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0017531COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Physical Therapy, P.C. Physical Therapist Current Accepting new patients
Denver Physical Therapy, P.C. Physical Therapist CurrentSince Feb 17, 2021 Accepting new patients
Denver Physical Therapy, P.C. Physical Therapist CurrentSince Feb 17, 2021 Accepting new patients

Locations

12311 Pine Bluffs Way
Unit 112
Parker, CO 80134
Phone (239) 239-8348

2600 Dallas Pkwy
Ste 290
Frisco, TX 75034
Phone (945) 260-0010

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1194318105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 MCGREGOR RESERVE DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019661",
            "telephone_number": "239-834-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12311 PINE BLUFFS WAY UNIT 112",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801347402",
            "telephone_number": "239-239-8348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTERS",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-19",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0017531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; 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.