Individual provider Active NPI

Ray John Oblanca

  • Physical Therapist
  • Colorado Springs, CO
National Provider Identifier
1235495045
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-10253 Issued in CO
Practice address
2150 Hollow Brook Dr.
Ste. 100
Colorado Springs, CO 80918-8414
Phone
(214) 218-4031
NPI assigned
Apr 5, 2012
Last updated
Sep 20, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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 PT-10253 CO Primary

Addresses

Primary practice location

2150 Hollow Brook Dr.
Ste. 100
Colorado Springs, CO 80918-8414

Mailing address

2150 Hollow Brook Dr.
Ste. 100
Colorado Springs, CO 80918-8414
Phone (214) 218-4031

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
PT-10253COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Feb 12, 2025 Accepting new patients
Paragon Outpatient Rehabilitation Services, LLC Physical Therapist CurrentSince Feb 12, 2025 Accepting new patients
Rea Rehabilitation Services Inc Past Accepting new patients

Locations

12105 Ambassador Dr
Colorado Springs, CO 80921
Phone (719) 481-5161

303 N Hurstbourne Pkwy
Ste 200
Louisville, KY 40222
Phone (502) 213-7572

Organizations & group practices 3

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": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1235495045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 HOLLOW BROOK DR.",
            "address_2": "STE. 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809188414",
            "telephone_number": "214-218-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 HOLLOW BROOK DR.",
            "address_2": "STE. 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809188414",
            "telephone_number": "214-218-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBLANCA",
        "first_name": "RAY JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-05",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PT-10253",
            "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 Sep 20, 2012; 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.