Individual provider Active NPI

Thomas J Champion, PT, DPT

  • Physical Therapist
  • Fort Collins, CO
National Provider Identifier
1417527466
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0017740 Issued in CO
Practice address
1300 Riverside Ave Ste 100
Fort Collins, CO 80524-4351
Phone
(970) 663-6142
NPI assigned
Jun 30, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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 0017740 CO Primary

Addresses

Primary practice location

1300 Riverside Ave Ste 100
Fort Collins, CO 80524-4351

Mailing address

107 W 29TH St Ste 100
Loveland, CO 80538-2200
Phone (970) 663-6142

Other practice location 1

107 W 29th St Ste 100
Loveland, CO 80538-2200
Phone (970) 663-6142 ext. 1

Other identifiers 1

IdentifierTypeStateIssuer
17740OtherCOPT LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211026001038 CO Practitioner - Physical Therapist in Private Practice 9537557400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rebound Sports and Physical Therapy P.CGroup PAC ID 0042106098, 21 clinicians

Practice addresses (Care Compare)

3500 John F Kennedy Pkwy
Suite 120
Fort Collins, CO 80525-2635
Phone (970) 663-6142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0017740COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rebound Sports & Physical Therapy, P.C. Physical Therapist CurrentSince Jul 6, 2021 Accepting new patients

Locations

3500 John F Kennedy Pkwy
Ste 120
Fort Collins, CO 80525
Phone (970) 663-6142

1300 Riverside Ave
Ste 100
Fort Collins, CO 80524
Phone (970) 663-6142

107 W 29th St
Ste 100
Loveland, CO 80538
Phone (970) 663-6142

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": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1417527466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W 29TH ST STE 100",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805382200",
            "telephone_number": "970-663-6142",
            "fax_number": "970-635-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 RIVERSIDE AVE STE 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244351",
            "telephone_number": "970-663-6142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 W 29th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Loveland",
            "state": "CO",
            "postal_code": "805382200",
            "country_code": "US",
            "telephone_number": "970-663-6142 x1",
            "fax_number": "970-635-3087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAMPION",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-30",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0017740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "17740",
            "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 Jun 4, 2026; 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.