Individual provider Active NPI

Charles Cary Gold, PT

  • Physical Therapist
  • Boulder, CO
National Provider Identifier
1295717916
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3341 Issued in CO
Practice address
5377 Manhattan Cir
Suite 102
Boulder, CO 80303-4344
Phone
(303) 449-7611
Fax
(303) 442-8786
NPI assigned
Nov 17, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

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 3341 CO Primary

Addresses

Primary practice location

5377 Manhattan Cir
Suite 102
Boulder, CO 80303-4344

Mailing address

5377 Manhattan Cir
Suite 102
Boulder, CO 80303-4333
Phone (303) 449-7611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050906000950 CO Practitioner - Physical Therapist in Private Practice 8426080953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5377 Manhattan Cir
Suite 102
Boulder, CO 80303-4344

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3341COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cary Gold Physical Therapy Inc Physical Therapist CurrentSince Jun 28, 2007 Accepting new patients

Locations

5377 Manhattan Cir
Ste 102
Boulder, CO 80303
Phone (303) 449-7611

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216166400000",
    "number": "1295717916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5377 MANHATTAN CIR",
            "address_2": "SUITE 102",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034333",
            "telephone_number": "303-449-7611",
            "fax_number": "303-442-8786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5377 MANHATTAN CIR",
            "address_2": "SUITE 102",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034344",
            "telephone_number": "303-449-7611",
            "fax_number": "303-442-8786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLD",
        "first_name": "CHARLES",
        "middle_name": "CARY",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2008-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "3341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.