Timothy Jordan Gotshall, DPT
Individual provider Active NPI Physical Therapist · Conifer, CO
NPI 1518468263 · NPPES record last updated Aug 9, 2022
Key facts
- NPI
- 1518468263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 0016673 (CO)
- Practice address
- 25577 Conifer Rd Unit 125
Conifer, CO 80433-9068 - Phone
- (303) 838-7444
- NPI assigned
- Feb 27, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Conifer Physical Therapy LLC
Practice addresses (Care Compare)
25577 Conifer Rd
Unit 125
Conifer, CO 80433-9068
Phone (303) 838-7444
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221017000062 | CO | Practitioner - Physical Therapist in Private Practice | 4688040652 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0016673 | CO | MD | Physical Therapist |
| 5501016553 | MI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Conifer Physical Therapy LLC | Physical Therapist | Current |
Accepting new patients |
| Michiana Home Care, LLC | Past | Accepting new patients |
Locations
25577 Conifer Rd
Unit 125
Conifer, CO 80433
Phone (303) 838-7444
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501016553 | MI | |
| Physical Therapist | 225100000X | 0016673 | CO | Yes |
Addresses
Primary practice location
25577 Conifer Rd Unit 125
Conifer, CO 80433-9068
Mailing address
25577 Conifer Rd Unit 125
Conifer, CO 80433-9068
Phone (423) 598-8686
Other providers in Conifer, CO
- Robert Douglas Gibson
- Clare Nicole Goldkamp
- William Goldstein
- Stephanie Gomolka
- Carla Gorrell
- Scott Grove
- Havens Ann Guenthner
- Oya Gulum
- Ori Michael Guteniak
- Alyssa Hahn
All providers in Conifer, CO · Physical Therapist in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.