Physiom, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

31928 Issued in CO

Legal business name

PHYSIOM, LLC

Practice address

1300 Oakridge Dr
130
Fort Collins, CO 80525-5564

Phone

(970) 377-9555

Fax

(970) 377-9559

NPI assigned

Dec 18, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Shandel Schroder

Title

Billing Agent

Phone

(303) 922-4636

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229558400000",
    "number": "1376789552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PHYSIOM LLC DEPT 2089",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802910001",
            "telephone_number": "303-922-4636",
            "fax_number": "303-922-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 OAKRIDGE DR",
            "address_2": "130",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255564",
            "telephone_number": "970-377-9555",
            "fax_number": "970-377-9559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIOM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-18",
        "last_updated": "2008-12-18",
        "status": "A",
        "authorized_official_last_name": "SCHRODER",
        "authorized_official_first_name": "SHANDEL",
        "authorized_official_title_or_position": "BILLING AGENT",
        "authorized_official_telephone_number": "303-922-4636",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CO",
            "license": "31928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Unknown Phoenix, LPC, CACIII
• Dana Photos
• Physical Medicine Center of the Rockies, PLLC
• Physiofit
• Physiom Associates, PLLC
• Jennifer Piasse
• Katie Piccolo, CLD
• Anna Marie Pickett, P.A.-C
• Elaine Sandra Pickett, M.A.
• Sonny Pickowitz, LCSW, MSW

• Specialist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2008; 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.