Organization Active NPI

Front Range Upper Extremity Rehab, LLC

  • Occupational Therapist
  • Boulder, CO
National Provider Identifier
1346863362
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
FRONT RANGE UPPER EXTREMITY REHAB, LLC
Practice address
2108 55TH St Ste 130
Boulder, CO 80301-2827
Phone
(720) 760-3222
Fax
(720) 664-6504
NPI assigned
May 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Authorized official

Name
Meredith Eve Hoerske, OTR/LNPI 1043325913
Title
Owner
Phone
(813) 431-3702

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

2108 55TH St Ste 130
Boulder, CO 80301-2827

Mailing address

555 Manhattan Dr Unit 203
Boulder, CO 80303-4079
Phone (720) 760-3222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200618000390 CO Part B Supplier - Clinic/Group Practice 5395167472 Receives reassigned benefits from 1 practitioner
Practice locations: Boulder, CO

National Provider Directory

National Provider Directory

Locations

2108 55th St
Ste 130
Boulder, CO 80301
Phone (720) 363-0139

3775 Iris Ave
Ste 2A
Boulder, CO 80301
Phone (720) 940-0145

3775 Iris Ave
Ste 2AB
Boulder, CO 80301
Phone (813) 431-3702

Practitioners & affiliated clinicians

Practitioners 1

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": "1590451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1346863362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 MANHATTAN DR UNIT 203",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034079",
            "telephone_number": "720-760-3222",
            "fax_number": "720-664-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 55TH ST STE 130",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012827",
            "telephone_number": "720-760-3222",
            "fax_number": "720-664-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONT RANGE UPPER EXTREMITY REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-26",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "HOERSKE",
        "authorized_official_first_name": "MEREDITH",
        "authorized_official_middle_name": "EVE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-431-3702",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.