Individual provider Active NPI

Dana Amundson, PT

  • Physical Therapist
  • Evergreen, CO
National Provider Identifier
1275610933
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
28577 Buffalo Park Rd Ste 205
Evergreen, CO 80439
Phone
(720) 900-3801
Fax
(720) 835-0056
NPI assigned
Nov 1, 2006
Last updated
Dec 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

28577 Buffalo Park Rd Ste 205
Evergreen, CO 80439

Mailing address

PO Box 848
Evergreen, CO 80437-0848
Phone (303) 514-8643

Other practice location 1

3333 S Wadsworth Blvd Ste 213
Lakewood, CO 80227-5122
Phone (303) 980-6762

Other identifiers 1

IdentifierTypeStateIssuer
9388OtherCOLICENSE#

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130529000791 CO Practitioner - Physical Therapist in Private Practice 4587802764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30810 Stagecoach Blvd
Suite 1016
Evergreen, CO 80439-7921
Phone (720) 900-2296

5764 Herzman Dr
Evergreen, CO 80439-5409

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Sport & Spine Physical Therapy PC Physical Therapist PastSince May 25, 1999 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1275610933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804370848",
            "telephone_number": "303-514-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28577 BUFFALO PARK RD STE 205",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "80439",
            "telephone_number": "720-900-3801",
            "fax_number": "720-835-0056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 S Wadsworth Blvd Ste 213",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802275122",
            "country_code": "US",
            "telephone_number": "303-980-6762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMUNDSON",
        "first_name": "DANA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE#",
            "identifier": "9388",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.