Individual provider Active NPI

Bernice I. Porter, O.T

  • Occupational Therapist
  • Colorado Springs, CO
National Provider Identifier
1295850857
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2201 Issued in CO
Practice address
1263 Lake Plaza Dr Ste 210
Colorado Springs, CO 80906-3511
Phone
(719) 623-1050
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2201 CO Primary

Addresses

Primary practice location

1263 Lake Plaza Dr Ste 210
Colorado Springs, CO 80906-3511

Mailing address

4112 Outlook Blvd
#96
Pueblo, CO 81008-1667
Phone (719) 562-6200

Other practice location 1

4112 Outlook Blvd
#96
Pueblo, CO 81008-1667
Phone (719) 562-6200

Other practice location 2

3010 N Circle Dr Ste 120
Colorado Springs, CO 80909-1182
Phone (719) 776-4888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161201001220 CO Practitioner - Occupational Therapist in Private Practice 3779863139 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centura Ventures, LLCGroup PAC ID 8628989043, 30 clinicians

Practice addresses (Care Compare)

4112 Outlook Blvd
Pueblo, CO 81008-1667
Phone (719) 562-6200

Merit-based Incentive Payment System (MIPS)

Final score
43.24 of 100Reported as group
Quality
73.53
Promoting interoperability
0
Improvement activities
0
Cost
70.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2201COMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Centura Ventures, LLC CurrentSince Sep 26, 2024 Accepting new patients
Orthopedic Centers of Colorado, LLC Occupational Therapist CurrentSince Mar 31, 2023 Accepting new patients
Orthopedic Centers of Colorado, LLC Occupational Therapist CurrentSince Mar 31, 2023 Accepting new patients

Locations

1411 S Potomac St
Ste 350
Aurora, CO 80012
Phone (303) 671-2134

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

1263 Lake Plaza Dr
Ste 210
Colorado Springs, CO 80906
Phone (719) 623-1050

8101 E Lowry Blvd
Ste 120
Lowry, CO 80230
Phone (303) 806-1998

4112 Outlook Blvd
Ste 96
Pueblo, CO 81008
Phone (719) 562-6200

Organizations & group practices 4

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1295850857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4112 OUTLOOK BLVD",
            "address_2": "#96",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081667",
            "telephone_number": "719-562-6200",
            "fax_number": "719-562-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1263 LAKE PLAZA DR STE 210",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063511",
            "telephone_number": "719-623-1050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4112 Outlook Blvd",
            "address_2": "#96",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810081667",
            "country_code": "US",
            "telephone_number": "719-562-6200",
            "fax_number": "719-562-6225",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3010 N Circle Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809091182",
            "country_code": "US",
            "telephone_number": "719-776-4888",
            "fax_number": "719-776-4860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTER",
        "first_name": "BERNICE",
        "middle_name": "I.",
        "credential": "O.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "2201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.