Cuchara Valley Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

CUCHARA VALLEY PHYSICAL THERAPY PC

Practice address

125 E 5TH St
Walsenburg, CO 81089-2009

Phone

(719) 738-3160

Fax

(719) 738-3170

NPI assigned

Oct 11, 2006

Organization subpart

No

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

Authorized official

Name

Diane Marie Koutnik, P.T.

Title

Owner

Phone

(719) 738-3160

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1316035348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E 5TH ST",
            "city": "WALSENBURG",
            "state": "CO",
            "postal_code": "810892020",
            "telephone_number": "719-738-3160",
            "fax_number": "719-738-3170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E 5TH ST",
            "city": "WALSENBURG",
            "state": "CO",
            "postal_code": "810892009",
            "telephone_number": "719-738-3160",
            "fax_number": "719-738-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUCHARA VALLEY PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KOUTNIK",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-738-3160",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87650886",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Walsenburg, CO
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.