Organization Active NPI

Anthem Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Colorado Springs, CO
National Provider Identifier
1205474657
Registry record updated Oct 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ANTHEM PHYSICAL THERAPY LLC
Practice address
1826 E Platte Ave Ste 114
Colorado Springs, CO 80909-5738
Phone
(719) 645-5052
Fax
(720) 419-3297
NPI assigned
Dec 17, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2023

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

Authorized official

Name
Dr. Daniel Seubert, PT, DPT, CERT. DNNPI 1417323833
Title
Owner/Physical Therapist
Phone
(719) 645-5052

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1826 E Platte Ave Ste 114
Colorado Springs, CO 80909-5738

Mailing address

10083 Manhattan Dr
Colorado Springs, CO 80924-7040
Phone (719) 645-5052

Other identifiers 1

IdentifierTypeStateIssuer
9000180490MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200221001033 CO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0648607101 Receives reassigned benefits from 1 practitioner
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Locations

6475 Wall St
Ste 140
Colorado Springs, CO 80918

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696118400000",
    "number": "1205474657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10083 MANHATTAN DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809247040",
            "telephone_number": "719-645-5052",
            "fax_number": "720-419-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1826 E PLATTE AVE STE 114",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095738",
            "telephone_number": "719-645-5052",
            "fax_number": "720-419-3297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHEM PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-17",
        "last_updated": "2023-10-01",
        "certification_date": "2023-10-01",
        "status": "A",
        "authorized_official_last_name": "SEUBERT",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "719-645-5052",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT, CERT. DN"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000180490",
            "state": "CO"
        }
    ],
    "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 Oct 1, 2023; 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.