Individual provider Active NPI

Ashley Waggoner, DPT

  • Physical Therapist
  • Louisville, CO
National Provider Identifier
1346815933
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0017640 Issued in CO
Practice address
315 W South Boulder Rd # 100and
Louisville, CO 80027-1156
Phone
(303) 666-4151
NPI assigned
May 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL.0017640 CO Primary

Addresses

Primary practice location

315 W South Boulder Rd # 100and
Louisville, CO 80027-1156

Mailing address

2910 Bluff St Apt 111
Boulder, CO 80301-1266
Phone (267) 474-5337

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210610002439 CO Practitioner - Physical Therapist in Private Practice 8921408014 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Alta Physical Therapy PCGroup PAC ID 0547253957, 7 clinicians

Practice addresses (Care Compare)

2955 Baseline Rd
Boulder, CO 80303-2356

3825 Iris Ave
Suite 300
Boulder, CO 80301-2070
Phone (303) 444-8707

3825 Iris Avenue
Suite 300
Boulder, CO 80301-2070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Nov 21, 2022 Accepting new patients
Coal Creek Physical Therapy, LLC Physical Therapist CurrentSince May 27, 2021 Accepting new patients
Alta Physical Therapy PC CurrentSince Jun 26, 2023 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Nov 21, 2022 Accepting new patients
Coal Creek Diagnostics, LLC PastSince May 27, 2021 Accepting new patients

Locations

350 Broadway St
Ste 50
Boulder, CO 80305
Phone (303) 499-2879

2955 Baseline Rd
Boulder, CO 80303
Phone (303) 444-8707

3825 Iris Ave
Ste 300
Boulder, CO 80301
Phone (303) 449-7284

315 W South Boulder Rd
Ste 100
Louisville, CO 80027
Phone (303) 601-6666

Organizations & group practices 6

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": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1346815933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 BLUFF ST APT 111",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011266",
            "telephone_number": "267-474-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W SOUTH BOULDER RD # 100AND",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800271156",
            "telephone_number": "303-666-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGONER",
        "first_name": "ASHLEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0017640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.