Individual provider Active NPI

Emmanuel Hernandez Aniag, PT, DPT

  • Geriatric Physical Therapist
  • Pueblo, CO
National Provider Identifier
1407337694
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
PTL0009246 Issued in CO
Practice address
855 Hunter Dr
Pueblo, CO 81001-1867
Phone
(715) 253-3743
NPI assigned
Aug 24, 2018
Last updated
Jan 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X PTL0009246 CO Primary

Addresses

Primary practice location

855 Hunter Dr
Pueblo, CO 81001-1867

Mailing address

2221 Shorthorn Drive
Pueblo, CO 81008-2800
Phone (715) 253-3743

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTL0009246COMDGeriatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1407337694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 SHORTHORN DRIVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082800",
            "telephone_number": "715-253-3743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 HUNTER DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011867",
            "telephone_number": "715-253-3743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANIAG",
        "first_name": "EMMANUEL",
        "middle_name": "HERNANDEZ",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-24",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "CO",
            "license": "PTL0009246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.