Individual provider Active NPI

Mary Faussett, MOTR/L, CHT

  • Rehabilitation Clinic/Center
  • Broomfield, CO
National Provider Identifier
1205373602
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
OT.0001533 Issued in CO
Practice address
8401 Arista PL
Broomfield, CO 80021-4154
Phone
(720) 777-9188
NPI assigned
Jan 23, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X OT.0001533 CO Primary

Addresses

Primary practice location

8401 Arista PL
Broomfield, CO 80021-4154

Mailing address

2026 Juniper Way
Erie, CO 80516-7966
Phone (720) 273-7532

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

State licenses

LicenseStateTypeSpecialty
OT.0001533COMDRehabilitation Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Colorado Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mfaussett8183@direct.childrenscolorado.org

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": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1205373602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2026 JUNIPER WAY",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805167966",
            "telephone_number": "720-273-7532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 ARISTA PL",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800214154",
            "telephone_number": "720-777-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUSSETT",
        "first_name": "MARY",
        "credential": "MOTR/L, CHT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-23",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "CO",
            "license": "OT.0001533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.