NPIMap

Organization Active NPI

Centura Ventures, LLC

Doing business as CS Cen PT Tri-Lakes

  • Physical Therapy Clinic/Center
  • Monument, CO
National Provider Identifier
1194357236
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
CENTURA VENTURES, LLC
Doing business as
CS Cen PT Tri-Lakes
Practice address
17230 Jackson Creek Pkwy Ste 170
Monument, CO 80132-7303
Phone
(719) 571-7080
Fax
(719) 571-7089
NPI assigned
Feb 6, 2020
Last updated
Nov 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Authorized official

Name
Ms. Debra Carpenter, RN
Title
VP, Ambulatory Services
Phone
(303) 765-6998

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

17230 Jackson Creek Pkwy Ste 170
Monument, CO 80132-7303

Mailing address

PO Box 801172
Kansas City, MO 64180-1172
Phone (800) 953-0104

Other identifiers 2

IdentifierTypeStateIssuer
1073882197OtherOLD NPI
21500851MedicaidCO

Other names 4

  • CS CEN PT TRI-LAKES Doing business as
  • Centura Physical Therapy at Tri-Lakes Other name
  • Colorado Sport and Spine Centers Other name
  • CommonSpirit Physical Therapy Tri-Lakes Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181221002214 CO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8628989043 Receives reassigned benefits from 32 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Woodland Park, CO; Pueblo, CO; Monument, CO; Colorado Springs, CO; Frisco, CO

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Centura Ventures LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the 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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1194357236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801172",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801172",
            "telephone_number": "800-953-0104",
            "fax_number": "303-765-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17230 JACKSON CREEK PKWY STE 170",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801327303",
            "telephone_number": "719-571-7080",
            "fax_number": "719-571-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTURA VENTURES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-06",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "VP, AMBULATORY SERVICES",
        "authorized_official_telephone_number": "303-765-6998",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OLD NPI",
            "identifier": "1073882197",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21500851",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CS CEN PT TRI-LAKES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CS CEN PT TRI-LAKES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Centura Physical Therapy at Tri-Lakes",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Colorado Sport and Spine Centers",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "CommonSpirit Physical Therapy Tri-Lakes",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Monument, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.