NPIMap

Organization Active NPI

Wyoming Physical Therapy PC

Doing business as Brookside Physical Therapy

  • Specialist
  • Colorado Springs, CO
National Provider Identifier
1235971912
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
WYOMING PHYSICAL THERAPY PC
Doing business as
Brookside Physical Therapy
Practice address
4935 N 30TH St Ste 100
Colorado Springs, CO 80919-3109
Phone
(719) 266-1710
Fax
(719) 623-0041
NPI assigned
Jun 12, 2024
Last updated
Jun 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Walter Wilson
Title
Owner
Phone
(720) 223-6177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

4935 N 30TH St Ste 100
Colorado Springs, CO 80919-3109

Mailing address

1217 S Greeley Hwy Ste a
Cheyenne, WY 82007-3063

Other names 1

  • Brookside Physical Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Brookside Physical Therapy14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1235971912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 S GREELEY HWY STE A",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820073063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4935 N 30TH ST STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809193109",
            "telephone_number": "719-266-1710",
            "fax_number": "719-623-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYOMING PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-223-6177"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookside Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 12, 2024; 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.