NPIMap

Organization Active NPI

Physiomed LLC

  • General Practice Physician
  • Englewood, CO
National Provider Identifier
1366801656
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PHYSIOMED LLC
Practice address
88 Inverness Cir E
A105
Englewood, CO 80112-5304
Phone
(303) 925-1050
NPI assigned
Feb 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Authorized official

Name
Tyler Corbin Fowler, DCNPI 1346202736
Title
Member
Phone
(303) 925-1050

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary
Sports Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251S0007X

Addresses

Primary practice location

88 Inverness Cir E
A105
Englewood, CO 80112-5304

Mailing address

88 Inverness Cir E
A105
Englewood, CO 80112-5304
Phone (303) 925-1050

Other names 1

  • Physical Dimensions IHG Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181220002830 CO Part B Supplier - Clinic/Group Practice 2961747845 Receives reassigned benefits from 1 practitioner
Practice locations: Englewood, CO

National Provider Directory

National Provider Directory

Locations

88 Inverness Cir E
Unit A105
Englewood, CO 80112
Phone (303) 350-9065

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455580800000",
    "number": "1366801656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 INVERNESS CIR E",
            "address_2": "A105",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801125304",
            "telephone_number": "303-925-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 INVERNESS CIR E",
            "address_2": "A105",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801125304",
            "telephone_number": "303-925-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIOMED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-16",
        "last_updated": "2016-02-16",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "CORBIN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "303-925-1050",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physical Dimensions IHG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Englewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.