NPIMap

Organization Active NPI

Dynamic Physical Therapy LLC

  • Physical Therapist
  • Pueblo, CO
National Provider Identifier
1275331001
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
DYNAMIC PHYSICAL THERAPY LLC
Practice address
1630 Fortino Blvd
Pueblo, CO 81008-1856
Phone
(719) 434-7044
Fax
(719) 375-1276
NPI assigned
Mar 6, 2025
Last updated
Mar 18, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
DYNAMIC PHYSICAL THERAPY, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Authorized official

Name
Stacey Lyn WelfelNPI 1144930504
Title
President
Phone
(719) 434-7044

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 Therapy Clinic/Center 261QP2000X
Physical Therapist 225100000X Primary

Addresses

Primary practice location

1630 Fortino Blvd
Pueblo, CO 81008-1856

Mailing address

5775 N Union Blvd
Colorado Springs, CO 80918-1744
Phone (719) 434-7044

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070319000668 CO Part B Supplier - Clinic/Group Practice 7810090446 Receives reassigned benefits from 10 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pueblo, CO; Colorado Springs, CO

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Dynamic Physical Therapy LLC3 organizations share this tax ID, including this one
Part of
Dynamic Physical Therapy LLC

Other organizations with this tax ID 2

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

Locations

5775 N Union Blvd
Colorado Springs, CO 80918
Phone (719) 434-7044

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": "1741219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742256000000",
    "number": "1275331001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 N UNION BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809181744",
            "telephone_number": "719-434-7044",
            "fax_number": "719-375-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 FORTINO BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081856",
            "telephone_number": "719-434-7044",
            "fax_number": "719-375-1276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC PHYSICAL THERAPY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DYNAMIC PHYSICAL THERAPY, LLC",
        "enumeration_date": "2025-03-06",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A",
        "authorized_official_last_name": "WELFEL",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-434-7044"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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, 2025; 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.