Breckenridge Rehabilitation Specialists LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

0010078 Issued in CO

Legal business name

BRECKENRIDGE REHABILITATION SPECIALISTS LLC

Doing business as

Breckenridge Physical Therapy

Practice address

106 N. French St
Suite 250
Breckenridge, CO 80424-4869

Phone

(970) 485-3421

Fax

(970) 453-1960

NPI assigned

Oct 16, 2014

Last updated

Oct 27, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Justin Michael Welch, PT, DPTNPI 1780690768

Title

Owner

Phone

(970) 485-3421

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Breckenridge Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 4

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.

• Justin Michael Welch, PT, DPT

  • Rehabilitation Clinic/Center
  • Breckenridge, CO
  • NPI 1780690768

  Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• Eleanor M Duncan, PT, DPT

  • Physical Therapist
  • Breckenridge, CO
  • NPI 1760851307
  Medicare reassignment Care Compare group
• Alexander Michael Kuck, DPT

  • Physical Therapist
  • Breckenridge, CO
  • NPI 1881364990
  Medicare reassignment Care Compare group
• Levon Balbay, P.T., MDT

  • Physical Therapist
  • Temecula, CA
  • NPI 1336290113
  NPD (past)

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

{
    "created_epoch": "1413417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414368000000",
    "number": "1285038471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 N. FRENCH ST PO BOX 4869",
            "address_2": "SUITE 250",
            "city": "BRECKENRIDGE",
            "state": "CO",
            "postal_code": "804244869",
            "telephone_number": "970-485-3421",
            "fax_number": "970-453-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 N. FRENCH ST",
            "address_2": "SUITE 250",
            "city": "BRECKENRIDGE",
            "state": "CO",
            "postal_code": "804244869",
            "telephone_number": "970-485-3421",
            "fax_number": "970-453-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRECKENRIDGE REHABILITATION SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-16",
        "last_updated": "2014-10-27",
        "status": "A",
        "authorized_official_last_name": "WELCH",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-485-3421",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "0010078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES PERSONAL NPI",
            "identifier": "1780690768",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Breckenridge Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joshua Williams Boudar, DC
• Breckenridge Acupuncture LLC
• Breckenridge Family Dental PLLC
• Breckenridge Medical Clinic, LLC
• Breckenridge Physical Therapy
• Breckenridge Signature Dental PLLC (Breckenridge Family Dental)
• Nicholas Brown
• Bruce E Noxon DPM LLC
• Whitney Madelyn Burke
• Jacqueline Burns

• Specialist in Breckenridge, CO
• Providers in Breckenridge, CO by specialty
• Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; 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.