Individual provider Active NPI

Carol Whittenburg, MPT

  • Physical Therapist
  • Lakewood, CO
National Provider Identifier
1417622887
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0004782 Issued in CO
Practice address
2800 Youngfield St
Lakewood, CO 80215-7210
Phone
(303) 233-4343
NPI assigned
Aug 9, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PTL.0004782 CO Primary

Addresses

Primary practice location

2800 Youngfield St
Lakewood, CO 80215-7210

Mailing address

2048 S Xenophon St
Lakewood, CO 80228-4357
Phone (720) 981-1502

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
PTL.0004782COMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1417622887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2048 S XENOPHON ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802284357",
            "telephone_number": "720-981-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 YOUNGFIELD ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802157210",
            "telephone_number": "303-233-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTENBURG",
        "first_name": "CAROL",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0004782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.