NPIMap

Organization Active NPI

Family Physical Therapy Center, P.C.

  • Specialist
  • Fort Collins, CO
National Provider Identifier
1407834377
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2850 Issued in CO
Legal business name
FAMILY PHYSICAL THERAPY CENTER, P.C.
Practice address
4674 Snow Mesa Dr
Suite 140
Fort Collins, CO 80528-8614
Phone
(970) 266-3850
Fax
(970) 266-3855
NPI assigned
Jan 2, 2006
Last updated
Nov 8, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Authorized official

Name
Stephen D Rivoire, P.T.NPI 1972571164
Title
President
Phone
(970) 266-3850

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
Specialist 174400000X 2850 CO Primary

Addresses

Primary practice location

4674 Snow Mesa Dr
Suite 140
Fort Collins, CO 80528-8614

Mailing address

4674 Snow Mesa Dr
Suite 140
Fort Collins, CO 80528-8615
Phone (970) 266-3850

Other identifiers 1

IdentifierTypeStateIssuer
07044035MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040921001277 CO Part B Supplier - Clinic/Group Practice 4385612985 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Collins, CO

National Provider Directory

National Provider Directory

Locations

1148 E Elizabeth St
Fort Collins, CO 80524
Phone (970) 221-5878

Practitioners & affiliated clinicians

Practitioners 55

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 55

NPI Registry JSON

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

{
    "created_epoch": "1136160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194480000000",
    "number": "1407834377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4674 SNOW MESA DR",
            "address_2": "SUITE 140",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805288615",
            "telephone_number": "970-266-3850",
            "fax_number": "970-266-3855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4674 SNOW MESA DR",
            "address_2": "SUITE 140",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805288614",
            "telephone_number": "970-266-3850",
            "fax_number": "970-266-3855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PHYSICAL THERAPY CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-02",
        "last_updated": "2007-11-08",
        "status": "A",
        "authorized_official_last_name": "RIVOIRE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-266-3850",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "2850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07044035",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; 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.