Colorado Premier Bodywork

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

COLORADO PREMIER BODYWORK

Practice address

5265 N Academy Blvd Ste 3300
Colorado Springs, CO 80918-4082

Phone

(719) 215-8722

NPI assigned

Oct 22, 2020

Organization subpart

Yes

Parent organization

COLORADO PREMIER BODYWORKAs reported in NPPES

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

Authorized official

Name

Nancy K Pour-Bakhtiar, LMT

Title

Owner

Phone

(719) 215-8722

Specialties & licenses 1

Addresses

Other names 1

• Structura Premier Bodywork Doing business as

Part of

Colorado Premier Bodywork

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603324800000",
    "number": "1457950271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5265 N ACADEMY BLVD STE 3300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809184082",
            "telephone_number": "719-215-8722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5265 N ACADEMY BLVD STE 3300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809184082",
            "telephone_number": "719-215-8722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO PREMIER BODYWORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLORADO PREMIER BODYWORK",
        "enumeration_date": "2020-10-22",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A",
        "authorized_official_last_name": "POUR-BAKHTIAR",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-215-8722",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Structura Premier Bodywork",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Colorado Permanente Medical Group, P.C.
• Colorado Permanente Medical Group, P.C.
• Colorado Permanente Medical Group, P.C.
• Colorado Permanente Medical Group, P.C.
• Colorado Permanente Medical Group, PC
• Colorado Premier Home Healthcare Services, LLC
• Colorado Pro Health Rehab-Kids & Adults LLC
• Colorado Professional Counseling Associates, LLC
• Colorado Professional Medical, Inc
• Colorado Psych Clinic LLC

• All providers in Colorado Springs, CO
• Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.