NPIMap

Organization Active NPI

Rivergate Physical Therapy, PC

  • Physical Therapist
  • Durango, CO
National Provider Identifier
1447449921
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
260503 Issued in CO
Legal business name
RIVERGATE PHYSICAL THERAPY, PC
Practice address
575 Rivergate
Suite 208
Durango, CO 81301-7487
Phone
(970) 259-2547
Fax
(970) 259-9653
NPI assigned
Oct 19, 2007
Last updated
Oct 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Authorized official

Name
Miss Amy M Gomb
Title
Office Manager/Coo
Phone
(970) 259-2547

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 260503 CO Primary

Addresses

Primary practice location

575 Rivergate
Suite 208
Durango, CO 81301-7487

Mailing address

575 Rivergate
Suite 208
Durango, CO 81301-7487
Phone (970) 259-2547

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080805000226 CO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9335213610 Receives reassigned benefits from 2 practitioners
Practice locations: Durango, CO

National Provider Directory

National Provider Directory

Locations

589 Trimble Ln
Durango, CO 81301
Phone (970) 259-2547

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1447449921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 RIVERGATE",
            "address_2": "SUITE 208",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017487",
            "telephone_number": "970-259-2547",
            "fax_number": "970-259-9653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 RIVERGATE",
            "address_2": "SUITE 208",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017487",
            "telephone_number": "970-259-2547",
            "fax_number": "970-259-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERGATE PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-19",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "GOMB",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER/COO",
        "authorized_official_telephone_number": "970-259-2547",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "260503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.