Individual provider Active NPI

Carol Jane Caudill, P. T.

  • Physical Therapist
  • Lafayette, CO
National Provider Identifier
1386979425
Registry record updated Oct 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10525 Issued in CO
Practice address
380 Empire Rd Ste 230
Lafayette, CO 80026-2677
Phone
(720) 890-1091
Fax
(720) 890-1098
NPI assigned
Oct 7, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2009

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 10525 CO Primary

Addresses

Primary practice location

380 Empire Rd Ste 230
Lafayette, CO 80026-2677

Mailing address

380 Empire Rd Ste 230
Lafayette, CO 80026-2677
Phone (720) 890-1091

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100607000764 CO Practitioner - Physical Therapist in Private Practice 4688704315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back to Action Physical TherapyGroup PAC ID 8426040643, 5 clinicians

Practice addresses (Care Compare)

150 Old Laramie TRL
Unit 100
Lafayette, CO 80026-7019
Phone (303) 685-8747

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10525COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Back to Action Physical Therapy Physical Therapist CurrentSince Jan 23, 2018 Accepting new patients

Locations

380 Empire Rd
Ste 230
Lafayette, CO 80026
Phone (720) 890-1091

150 Old Laramie Trl
Unit 100
Lafayette, CO 80026
Phone (303) 665-8747

Organizations & group practices 1

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": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254873600000",
    "number": "1386979425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 EMPIRE RD STE 230",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262677",
            "telephone_number": "720-890-1091",
            "fax_number": "720-890-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 EMPIRE RD STE 230",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262677",
            "telephone_number": "720-890-1091",
            "fax_number": "720-890-1098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAUDILL",
        "first_name": "CAROL",
        "middle_name": "JANE",
        "credential": "P. T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-07",
        "last_updated": "2009-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "10525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2009; 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.