NPIMap

Organization Active NPI

Physical Therapy of Boulder

  • Physical Therapist
  • Boulder, CO
National Provider Identifier
1215056023
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3177 Issued in CO
Legal business name
PHYSICAL THERAPY OF BOULDER
Practice address
3020 Carbon PL Ste 330
Boulder, CO 80301-6148
Phone
(303) 938-1141
Fax
(303) 938-1311
NPI assigned
Mar 29, 2007
Last updated
Apr 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Authorized official

Name
Douglas Len Hanna, MS PTNPI 1548388853
Title
Owner Physical Therapist
Phone
(303) 938-1141

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 3177 CO Primary

Addresses

Primary practice location

3020 Carbon PL Ste 330
Boulder, CO 80301-6148

Mailing address

3020 Carbon PL Ste 330
Boulder, CO 80301-6148
Phone (303) 938-1141

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040908000410 CO Part B Supplier - Clinic/Group Practice 6002882339 Receives reassigned benefits from 28 practitioners
Practice locations: Boulder, CO

National Provider Directory

National Provider Directory

Locations

3020 Carbon Pl
Ste 330
Boulder, CO 80301
Phone (303) 938-1141

3020 Carbon Pl
Boulder, CO 80301
Phone (303) 938-1141

3020 Carbon Pl
Ste 205
Boulder, CO 80301

1200 28th St
Ste 305
Boulder, CO 80303
Phone (303) 938-1141

806 S Public Rd
Ste 300
Lafayette, CO 80026
Phone (720) 406-7408

1325 Dry Creek Dr
Ste 204
Longmont, CO 80503
Phone (303) 776-5535

Practitioners & affiliated clinicians

Practitioners 40

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.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1215056023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CARBON PL STE 330",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803016148",
            "telephone_number": "303-938-1141",
            "fax_number": "303-938-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 CARBON PL STE 330",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803016148",
            "telephone_number": "303-938-1141",
            "fax_number": "303-938-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY OF BOULDER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "HANNA",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "LEN",
        "authorized_official_title_or_position": "OWNER PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "303-938-1141",
        "authorized_official_credential": "MS PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "3177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.