Individual provider Active NPI

Chantal Marie McDonald, M.S.P.T.

  • Physical Therapist
  • Longmont, CO
National Provider Identifier
1225049158
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3021 Issued in CO
Practice address
1551 Professional LN
#145
Longmont, CO 80501-6972
Phone
(720) 494-3290
Fax
(720) 494-3294
NPI assigned
Aug 9, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3021 CO Primary

Addresses

Primary practice location

1551 Professional LN
#145
Longmont, CO 80501-6972

Mailing address

6979 S Holly Cir
Ste 105
Centennial, CO 80112-1577
Phone (303) 694-2295

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180924002369 CO Practitioner - Physical Therapist in Private Practice 6709137169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coal Creek Physical Therapy, LLCGroup PAC ID 9133014160, 13 clinicians

Practice addresses (Care Compare)

315 W S Boulder Rd
Suite 100
Louisville, CO 80027-1157
Phone (303) 666-4151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3021COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Coal Creek Physical Therapy, LLC Physical Therapist CurrentSince Aug 13, 2018 Accepting new patients
Coal Creek Diagnostics, LLC PastSince Aug 13, 2018 Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients

Locations

315 W South Boulder Rd
Ste 100
Louisville, CO 80027
Phone (303) 666-4151

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1225049158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6979 S HOLLY CIR",
            "address_2": "STE 105",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121577",
            "telephone_number": "303-694-2295",
            "fax_number": "303-694-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 PROFESSIONAL LN",
            "address_2": "#145",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016972",
            "telephone_number": "720-494-3290",
            "fax_number": "720-494-3294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "CHANTAL",
        "middle_name": "MARIE",
        "credential": "M.S.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "3021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.