Individual provider Active NPI

Jennifer A Weaver-Crookham, PT

  • Physical Therapist
  • Glendale, CO
National Provider Identifier
1447248307
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7242 Issued in CO
Practice address
720 S Colorado Blvd
Suite 200-a, Dept 914
Glendale, CO 80246-1912
Phone
(303) 584-8288
Fax
(866) 210-2804
NPI assigned
Oct 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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 7242 CO Primary

Addresses

Primary practice location

720 S Colorado Blvd
Suite 200-a, Dept 914
Glendale, CO 80246-1912

Mailing address

720 S Colorado Blvd
Suite 200-a, Dept 914
Glendale, CO 80246-1912
Phone (303) 584-8000

Other identifiers 1

IdentifierTypeStateIssuer
066615OtherCOMEDICARE GROUP #

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
7242COMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202688000000",
    "number": "1447248307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 S COLORADO BLVD",
            "address_2": "SUITE 200-A, DEPT 914",
            "city": "GLENDALE",
            "state": "CO",
            "postal_code": "802461912",
            "telephone_number": "303-584-8000",
            "fax_number": "303-584-8141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 S COLORADO BLVD",
            "address_2": "SUITE 200-A, DEPT 914",
            "city": "GLENDALE",
            "state": "CO",
            "postal_code": "802461912",
            "telephone_number": "303-584-8288",
            "fax_number": "866-210-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER-CROOKHAM",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2008-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "7242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "066615",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.