Active NPI
Andrew Stewart
- Physical Therapist
- Broomfield, CO
National Provider Identifier
1477962116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0012830
- Practice address
- 11575 Main St
100
Broomfield, CO 80020-2780 - Phone
- (303) 467-2288
- NPI assigned
- Aug 7, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 0012830 | CO | Primary |
Addresses
Primary practice location
11575 Main St
100
Broomfield, CO 80020-2780
Mailing address
11575 Main St
100
Broomfield, CO 80020-2780
Phone (303) 467-2288
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0012830 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443571200000",
"number": "1477962116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11575 MAIN ST",
"address_2": "100",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800202780",
"telephone_number": "303-467-2288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11575 MAIN ST",
"address_2": "100",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800202780",
"telephone_number": "303-467-2288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "ANDREW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-08-07",
"last_updated": "2015-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "0012830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broomfield, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.