Individual provider Active NPI

Dominique M Beaufils-Brehm, PT

  • Physical Therapist
  • Denver, CO
National Provider Identifier
1487642344
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5909 Issued in CO
Practice address
4567 E 9TH Ave
Attn Rose Inpatient Rehab
Denver, CO 80220-3908
Phone
(303) 320-2818
Fax
(303) 320-7117
NPI assigned
Oct 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5909 CO Primary

Addresses

Primary practice location

4567 E 9TH Ave
Attn Rose Inpatient Rehab
Denver, CO 80220-3908

Mailing address

4567 E 9TH Ave
Attn Rose Inpatient Rehab
Denver, CO 80220-3908
Phone (303) 320-2818

Other identifiers 1

IdentifierTypeStateIssuer
64626032MedicaidCO

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5909COMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201651200000",
    "number": "1487642344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4567 E 9TH AVE",
            "address_2": "ATTN ROSE INPATIENT REHAB",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802203908",
            "telephone_number": "303-320-2818",
            "fax_number": "303-320-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4567 E 9TH AVE",
            "address_2": "ATTN ROSE INPATIENT REHAB",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802203908",
            "telephone_number": "303-320-2818",
            "fax_number": "303-320-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUFILS-BREHM",
        "first_name": "DOMINIQUE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2008-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "5909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64626032",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; 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.