Individual provider Active NPI

Carli Menzel Brakefield, PT, DPT

  • Pediatric Physical Therapist
  • Denver, CO
National Provider Identifier
1417407495
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PTL0015767 Issued in CO
Practice address
9900 E Iliff Ave Ste 304
Denver, CO 80231-3462
Phone
(303) 636-5600
NPI assigned
Oct 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PTL0015767 CO Primary

Addresses

Primary practice location

9900 E Iliff Ave Ste 304
Denver, CO 80231-3462

Mailing address

9900 E Iliff Ave
Denver, CO 80231-3462
Phone (303) 636-5600

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL0015767COMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Human Services Physical Therapist Past Accepting new patients

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": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1417407495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 E ILIFF AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802313462",
            "telephone_number": "303-636-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 E ILIFF AVE STE 304",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802313462",
            "telephone_number": "303-636-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAKEFIELD",
        "first_name": "CARLI",
        "middle_name": "MENZEL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-13",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CO",
            "license": "PTL0015767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.