NPIMap

Organization Active NPI

Pueblo Rehab & Orthopedic Therapy LLC

Doing business as PRO Therapy

  • Physical Therapist
  • Pueblo, CO
National Provider Identifier
1245212711
Registry record updated Mar 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PUEBLO REHAB & ORTHOPEDIC THERAPY LLC
Doing business as
PRO Therapy
Practice address
3525 Spaulding Ave
Pueblo, CO 81008-2208
Phone
(719) 542-4444
Fax
(719) 543-1990
NPI assigned
Nov 18, 2005
Last updated
Mar 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2016

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

Authorized official

Name
Miss Lyndsey Brooke Langdon
Title
Office Manager
Phone
(719) 542-4444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

3525 Spaulding Ave
Pueblo, CO 81008-2208

Mailing address

3525 Spaulding Avenue
Pueblo, CO 81008
Phone (719) 542-4444

Other identifiers 3

IdentifierTypeStateIssuer
PU653628OtherBLUE SHIELD
187602900OtherDOL
CK6274OtherCORAILROAD

Other names 1

  • PRO Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040909000440 CO Part B Supplier - Clinic/Group Practice 0547236697 Receives reassigned benefits from 4 practitioners
Practice locations: Pueblo, CO

National Provider Directory

National Provider Directory

Locations

3575 Spaulding Ave
CO 81008

3525 E Spaulding Ave
Pueblo, CO 81008
Phone (719) 542-4444

4017 Jerry Murphy Rd
Pueblo, CO 81001
Phone (719) 542-4444

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458259200000",
    "number": "1245212711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 SPAULDING AVENUE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81008",
            "telephone_number": "719-542-4444",
            "fax_number": "719-543-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 SPAULDING AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082208",
            "telephone_number": "719-542-4444",
            "fax_number": "719-543-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUEBLO REHAB & ORTHOPEDIC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2016-03-18",
        "status": "A",
        "authorized_official_last_name": "LANGDON",
        "authorized_official_first_name": "LYNDSEY",
        "authorized_official_middle_name": "BROOKE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "719-542-4444",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "PU653628",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL",
            "identifier": "187602900",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "CK6274",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRO Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; 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.