Organization Active NPI

Good News Physical Therapy, PLLC

  • Physical Therapy Clinic/Center
  • La Junta, CO
National Provider Identifier
1255959565
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
GOOD NEWS PHYSICAL THERAPY, PLLC
Practice address
1220 E 3Rd St
La Junta, CO 81050-1907
Phone
(719) 225-2296
Fax
(719) 931-5619
NPI assigned
Jul 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Authorized official

Name
Amy Proctor, DPTNPI 1144889916
Title
Owner
Phone
(719) 469-1940

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1220 E 3Rd St
La Junta, CO 81050-1907

Mailing address

1220 E 3Rd St
La Junta, CO 81050-1907
Phone (719) 469-1940

Other identifiers 1

IdentifierTypeStateIssuer
9000201915MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL MWTherapy

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200910000030 CO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7517385461 Receives reassigned benefits from 2 practitioners
Practice locations: La Junta, CO

National Provider Directory

National Provider Directory

Locations

1220 E 3rd St
La Junta, CO 81050
Phone (719) 225-2296

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646784000000",
    "number": "1255959565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 E 3RD ST",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810501907",
            "telephone_number": "719-469-1940",
            "fax_number": "719-931-5619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 E 3RD ST",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810501907",
            "telephone_number": "719-225-2296",
            "fax_number": "719-931-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD NEWS PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-13",
        "last_updated": "2022-03-09",
        "certification_date": "2022-02-22",
        "status": "A",
        "authorized_official_last_name": "PROCTOR",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-469-1940",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000201915",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "MWTherapy",
            "affiliation": "N",
            "endpointDescription": "Still processing",
            "address_1": "8694 State Highway 194",
            "city": "Las Animas",
            "state": "CO",
            "country_code": "US",
            "postal_code": "810549414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Junta, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; 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.