Colosseum Physical Therapy & Performance, LLC

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

Legal business name

COLOSSEUM PHYSICAL THERAPY & PERFORMANCE, LLC

Practice address

500 E Main St
Farmington, NM 87401-2712

Phone

(607) 725-3972

NPI assigned

Aug 2, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Shell, DPTNPI 1962827568

Title

Physical Therapist/Owner

Phone

(607) 725-3972

Specialties & licenses 1

Addresses

Other names 1

• Colosseum Other name

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Shell, DPT

  • Physical Therapist
  • Farmington, NM
  • NPI 1962827568

  NM, Physical Therapist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690934400000",
    "number": "1457033102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E MAIN ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874012712",
            "telephone_number": "607-725-3972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E MAIN ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874012712",
            "telephone_number": "607-725-3972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLOSSEUM PHYSICAL THERAPY & PERFORMANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-02",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A",
        "authorized_official_last_name": "SHELL",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "607-725-3972",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colosseum",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Leah Collette, CSW
• Neil Collinge, M.D.
• Jacob Shonota Collins
• Percy E Collyer, PHARMD
• Francisco Colon, MD
• Amanda Colyer
• Comprehensive Sleep Solutions, LLC
• Jessica A Conklin, CNP
• Scott J Conklin, PHARM.D.
• Carol Connelly, CNP

• All providers in Farmington, NM
• Orthopedic Physical Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; 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.