Active NPI
Manual Edge Physical Therapy Specialists LLC
- Physical Therapist
- Monument, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- MANUAL EDGE PHYSICAL THERAPY SPECIALISTS LLC
- Practice address
- 1840 Woodmoor Dr Ste 106
Monument, CO 80132-9098 - Phone
- (719) 694-9747
- Fax
- (719) 694-9832
- NPI assigned
- Nov 26, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Timothy D Bonack
- Title
- Ceo/Owner
- Phone
- (719) 694-8342
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
1840 Woodmoor Dr Ste 106
Monument, CO 80132-9098
Mailing address
1840 Woodmoor Dr Ste 106
Monument, CO 80132-9098
Phone (719) 694-9747
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | CO |
National Provider Directory
National Provider Directory- Tax ID family
- Manual Edge Physical Therapy Specialists LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Orthopedic Physical Therapist
- Colorado Springs, CO
- NPI 1609542109
Locations
1840 Woodmoor Dr
Ste 106
Monument, CO 80132
Phone (719) 653-0450
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Orthopedic Physical Therapist
- Colorado Springs, CO
- NPI 1609838432
-
- Physical Therapist
- Monument, CO
- NPI 1699605675
-
- Physical Therapist
- Oxford, NC
- NPI 1346048956
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732579200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1732579200000",
"number": "1265258024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1840 WOODMOOR DR STE 106",
"city": "MONUMENT",
"state": "CO",
"postal_code": "801329098",
"telephone_number": "719-694-9747",
"fax_number": "719-694-9832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1840 WOODMOOR DR STE 106",
"city": "MONUMENT",
"state": "CO",
"postal_code": "801329098",
"telephone_number": "719-694-9747",
"fax_number": "719-694-9832"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MANUAL EDGE PHYSICAL THERAPY SPECIALISTS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-11-26",
"last_updated": "2024-11-26",
"certification_date": "2024-11-26",
"status": "A",
"authorized_official_last_name": "BONACK",
"authorized_official_first_name": "TIMOTHY",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "CEO/OWNER",
"authorized_official_telephone_number": "719-694-8342"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monument, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.