Organization Active NPI

Holistic Physical Therapy LLC

  • Physical Therapist
  • Boulder, CO
National Provider Identifier
1295783678
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7232 Issued in CO
Legal business name
HOLISTIC PHYSICAL THERAPY LLC
Practice address
3010 14TH St
Boulder, CO 80304-2610
Phone
(720) 226-1448
NPI assigned
May 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Authorized official

Name
Michele Elise Kreisberg, PT
Title
Owner
Phone
(720) 226-1448

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 7232 CO Primary

Addresses

Primary practice location

3010 14TH St
Boulder, CO 80304-2610

Mailing address

PO Box 21150
Boulder, CO 80308-4150
Phone (303) 546-9158

Other identifiers 2

IdentifierTypeStateIssuer
C806277OtherCOMEDICARE PTAN
HO675746OtherCOBCBS

National Provider Directory

National Provider Directory

Locations

8859 Fox Dr
Ste 100
Thornton, CO 80260

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201651200000",
    "number": "1295783678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21150",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803084150",
            "telephone_number": "303-546-9158",
            "fax_number": "303-546-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 14TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803042610",
            "telephone_number": "720-226-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2008-01-30",
        "status": "A",
        "authorized_official_last_name": "KREISBERG",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "ELISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-226-1448",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "7232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "C806277",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "HO675746",
            "state": "CO"
        }
    ],
    "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 Jan 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.