Dreiling Jack Green, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL.0017314 Issued in CO

Practice address

360 Peak One Dr Ste 190
Frisco, CO 80443-5868

Phone

(970) 668-0888

Fax

(970) 668-0227

NPI assigned

Feb 23, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Roaring Fork Rehab & Performance LLC

  • Sports Physical Therapist
  • Glenwood Springs, CO
  • NPI 1184574733
  NPD Authorized official

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1265026009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2472 PATTERSON RD UNIT 8",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051100",
            "telephone_number": "970-241-0202",
            "fax_number": "970-245-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 PEAK ONE DR STE 190",
            "city": "FRISCO",
            "state": "CO",
            "postal_code": "804435868",
            "telephone_number": "970-668-0888",
            "fax_number": "970-668-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "DREILING",
        "middle_name": "JACK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-23",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0017314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Vogel Gotantas, PT
• John E Gottlieb, M.D.
• William E Gottlieb, M.D.
• John Loren Graham, D.C.
• Scott Gray, R.PH.
• Kristen Griffin, LCSW, LAC
• Heidi Gruber, PA-C
• Javier Gutierrez, MD
• Kelvin Ha, DDS
• Fiona Hahn, RN

• Physical Therapist in Frisco, CO
• Providers in Frisco, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.