Active NPI
Colonie Elder
- Rehabilitation Practitioner
- Fort Bragg, CA
National Provider Identifier
1194678318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 215 S Main St
Fort Bragg, CA 95437-4210 - Phone
- (707) 463-3300
- NPI assigned
- Feb 17, 2026
- Last updated
- Feb 17, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | NU | Primary |
Addresses
Primary practice location
215 S Main St
Fort Bragg, CA 95437-4210
Mailing address
215 S Main St
Fort Bragg, CA 95437-4210
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tapestry Family Services | Past | Accepting new patients | |
| Tapestry Family Services | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Fort Bragg, CA
- NPI 1710799283
-
- Community/Behavioral Health Agency
- Ukiah, CA
- NPI 1932241833
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1771286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771286400000",
"number": "1194678318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 S MAIN ST",
"city": "FORT BRAGG",
"state": "CA",
"postal_code": "954374210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 S MAIN ST",
"city": "FORT BRAGG",
"state": "CA",
"postal_code": "954374210",
"telephone_number": "707-463-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDER",
"first_name": "COLONIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-02-17",
"last_updated": "2026-02-17",
"certification_date": "2026-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Bragg, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.