Individual provider Active NPI

Jonathan Brown, PTL

  • Physical Therapist
  • Colorado Springs, CO
National Provider Identifier
1205102605
Registry record updated Apr 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11601 Issued in CO
Practice address
2140 Hollow Brook Dr
Suite 200
Colorado Springs, CO 80918-1452
Phone
(719) 596-5000
NPI assigned
Mar 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 00000 CO
Physical Therapist 225100000X 11601 CO Primary

Addresses

Primary practice location

2140 Hollow Brook Dr
Suite 200
Colorado Springs, CO 80918-1452

Mailing address

2140 Hollow Brook Dr
Suite 200
Colorado Springs, CO 80918-1452
Phone (719) 596-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151214001622 CO Practitioner - Physical Therapist in Private Practice 5092016253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Physical TherapyGroup PAC ID 2860469525, 5 clinicians

Practice addresses (Care Compare)

7621 Austin Bluffs Pkwy
Colorado Springs, CO 80920-2904
Phone (719) 596-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00000COMDClinical Cytogenetics Physician
11601COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Physical Therapy Physical Therapist CurrentSince Feb 16, 2012 Accepting new patients

Locations

2140 Hollow Brook Dr
Ste 200
Colorado Springs, CO 80918
Phone (719) 596-5000

7621 Austin Bluffs Pkwy
Unit 200
Colorado Springs, CO 80920
Phone (719) 569-5000

Organizations & group practices 1

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": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333670400000",
    "number": "1205102605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 HOLLOW BROOK DR",
            "address_2": "SUITE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809181452",
            "telephone_number": "719-596-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 HOLLOW BROOK DR",
            "address_2": "SUITE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809181452",
            "telephone_number": "719-596-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JONATHAN",
        "credential": "PTL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-29",
        "last_updated": "2012-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "00000",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "11601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.