Individual provider Active NPI

Mary Ellington Pomeroy Wintersieck, PT, DPT

  • Physical Therapist
  • Thornton, CO
National Provider Identifier
1437405644
Registry record updated Dec 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0011783 Issued in CO
Practice address
9351 Grant St Ste 430
Thornton, CO 80229-4365
Phone
(303) 280-1211
NPI assigned
Jul 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2017

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 PTL.0011783 CO Primary

Addresses

Primary practice location

9351 Grant St Ste 430
Thornton, CO 80229-4365

Mailing address

9351 Grant St Ste 430
Thornton, CO 80229-4365
Phone (303) 280-1211

Other names 1

  • Dr. Mary Ellington Pomeroy Former name

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
PTL.0011783COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates Inc Past Accepting new patients
Rezac & Associates Physical Therapy, LLC Physical Therapist PastSince Nov 16, 2010 Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients

Organizations & group practices 3

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": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1437405644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9351 GRANT ST STE 430",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294365",
            "telephone_number": "303-280-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9351 GRANT ST STE 430",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294365",
            "telephone_number": "303-280-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTERSIECK",
        "first_name": "MARY",
        "middle_name": "ELLINGTON POMEROY",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-25",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0011783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "POMEROY",
            "middle_name": "ELLINGTON",
            "prefix": "DR.",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; 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.