NPIMap

Organization Active NPI

Impact Sports Medicine PC

  • Physical Therapy Clinic/Center
  • Broomfield, CO
National Provider Identifier
1306927496
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
IMPACT SPORTS MEDICINE PC
Practice address
3303 W 144TH Ave
Suite 105
Broomfield, CO 80023-9464
Phone
(303) 446-2200
Fax
(303) 446-2201
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Authorized official

Name
Mr. Keith Eric Christianssen, PT ATC MTC
Title
Owner
Phone
(303) 446-2200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

3303 W 144TH Ave
Suite 105
Broomfield, CO 80023-9464

Mailing address

PO Box 270217
Louisville, CO 80027-5003
Phone (303) 446-2200

National Provider Directory

National Provider Directory

Locations

11575 Main St
Unit 100
Broomfield, CO 80020
Phone (303) 467-2288

3303 W 144th Ave
Unit 105
Broomfield, CO 80023
Phone (303) 444-2529

11025 Dover St
Unit 400
Westminster, CO 80021
Phone (303) 446-2200

Practitioners & affiliated clinicians

Practitioners 12

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": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406592000000",
    "number": "1306927496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270217",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800275003",
            "telephone_number": "303-446-2200",
            "fax_number": "303-446-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 W 144TH AVE",
            "address_2": "SUITE 105",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800239464",
            "telephone_number": "303-446-2200",
            "fax_number": "303-446-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT SPORTS MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2014-07-29",
        "status": "A",
        "authorized_official_last_name": "CHRISTIANSSEN",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-446-2200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT ATC MTC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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.