Aqua Dynamics Physical Therapy LLC

Organization Active NPI Physical Therapy Clinic/Center · Fort Collins, CO

NPI 1508569294 · NPPES record last updated May 20, 2025

Key facts

NPI
1508569294
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapy Clinic/Center 261QP2000X
Legal business name
AQUA DYNAMICS PHYSICAL THERAPY LLC
Practice address
1015 W Horsetooth Rd Unit 103
Fort Collins, CO 80526-5980
Phone
(626) 429-0411
NPI assigned
Mar 23, 2023
Organization subpart
No

Authorized official

Name
Rachel Kristine Rantanen, DPT NPI 1679081210
Title
PT/Owner
Phone
(970) 449-0832

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 3

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230517001074 CO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4385000363 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Collins, CO

National Provider Directory

Tax ID family
Aqua Dynamics Physical Therapy LLC (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225100000X
Physical Therapy Clinic/Center 261QP2000X Yes

Addresses

Primary practice location

1015 W Horsetooth Rd Unit 103
Fort Collins, CO 80526-5980

Mailing address

1832 Golden Willow CT
Fort Collins, CO 80528-6391
Phone (626) 429-0411

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 20, 2025.

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747699200000",
    "number": "1508569294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1832 GOLDEN WILLOW CT",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805286391",
            "telephone_number": "626-429-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 W HORSETOOTH RD UNIT 103",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805265980",
            "telephone_number": "626-429-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AQUA DYNAMICS PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-23",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "RANTANEN",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "KRISTINE",
        "authorized_official_title_or_position": "PT/OWNER",
        "authorized_official_telephone_number": "970-449-0832",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

All providers in Fort Collins, CO · Physical Therapy Clinic/Center in Colorado

Sources for this page

Verify at the official NPI Registry.