Gordon David Weidemann, MSPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

5081 Issued in CO

Practice address

818 Colorado Ave, Suite 300
Glenwood Springs, CO 81601

Phone

(970) 379-5197

Fax

(970) 945-0409

NPI assigned

Jun 28, 2010

Last updated

Nov 29, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1326359076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 3053",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "81602",
            "telephone_number": "970-379-5197",
            "fax_number": "970-947-9048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 COLORADO AVE, SUITE 300",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "81601",
            "telephone_number": "970-379-5197",
            "fax_number": "970-945-0409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDEMANN",
        "first_name": "GORDON",
        "middle_name": "DAVID",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-28",
        "last_updated": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "5081",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CO",
            "license": "5081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "5081",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Joshua Watson, D.C.
• Leslie L Way, LPC
• Jacqueline Weast, LCSW
• Sierra Rose Weast, BSW
• Drew Wegert, CST, CSFA
• Mary Kathleen Wentzel, LPCC
• Thomas Wessel, DC
• Western Slope Oncology Associates PC
• Robyn L Whaley, RN
• Raquel M. Whitehead, R.N.

• Orthopedic Physical Therapist in Glenwood Springs, CO
• Providers in Glenwood Springs, CO by specialty
• Orthopedic Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.