Brookside Physical Therapy PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

BROOKSIDE PHYSICAL THERAPY PC

Practice address

8859 Fox Drive
Suite 300
Thornton, CO 80260

Phone

(303) 428-4646

Fax

(303) 429-6255

NPI assigned

Nov 6, 2006

Organization subpart

No

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

Authorized official

Name

Susan Moore, MS PT

Title

President

Phone

(303) 428-4646

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Outpatient physical therapy / speech pathology certification: CCN 066587

Legal name

BROOKSIDE PHYSICAL THERAPY, PC

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Aug 8, 1995

Last certification

Mar 3, 2021

Ownership / control type

Combination Government & Voluntary

Facility address

8859 Fox Dr #300
Thornton, CO 80260

Locations

Practitioners 3

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

• Malissa S Ross, MS, PT

  • Physical Therapist
  • Thornton, CO
  • NPI 1881921435
  NPD (past)
• Taylor Renee Vaughan, PT, DPT, CLT

  • Physical Therapist
  • Thornton, CO
  • NPI 1528513058
  NPD (past)
• Jaime Yee West, PT

  • Physical Therapy Clinic/Center
  • Thornton, CO
  • NPI 1487868915
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330041600000",
    "number": "1467531707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8859 FOX DRIVE",
            "address_2": "SUITE 300",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "80260",
            "telephone_number": "303-428-4646",
            "fax_number": "303-429-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8859 FOX DRIVE",
            "address_2": "SUITE 300",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "80260",
            "telephone_number": "303-428-4646",
            "fax_number": "303-429-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSIDE PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2012-02-24",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-428-4646",
        "authorized_official_credential": "MS PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devon Erin Broderick, B.A.
• Eric H Broecker, OD
• Susan C Bromell, DDS
• Colby Tyler Brooks
• Stephanie Marie Brooks, RN
• Lucie W Brossard, M.A., LPC
• Jamie Brotherton
• Carissa Lanae Brown, APRN
• Casey Brown, M.A.
• Darcy Rene Brown, LCSW

• Physical Therapy Clinic/Center in Thornton, CO
• Providers in Thornton, CO by specialty
• Physical Therapy Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.