Individual provider Active NPI

Elizabeth Liese, DPT

  • Physical Therapist
  • Greeley, CO
National Provider Identifier
1518685270
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0018633 Issued in CO
Practice address
4617 W 20TH St
Greeley, CO 80634-3207
Phone
(970) 352-9022
NPI assigned
Aug 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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 0018633 CO Primary

Addresses

Primary practice location

4617 W 20TH St
Greeley, CO 80634-3207

Mailing address

5070 Exposition Dr Apt B417
Johnstown, CO 80534-6538

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Fax

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220919000839 CO Practitioner - Physical Therapist in Private Practice 8729463328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4617 W 20TH St
Unit a
Greeley, CO 80634-3207

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0018633COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Holdings Inc CurrentSince Jun 8, 2022 Accepting new patients
Select Physical Therapy Holdings Inc Physical Therapist Current Accepting new patients
Select Physical Therapy Holdings, Inc. CurrentSince Jun 8, 2022 Accepting new patients

Locations

6980 Mesa Ridge Pkwy
Ste 100
Fountain, CO 80817
Phone (719) 391-0044

730 14th St SW
Ste 200
Loveland, CO 80537
Phone (970) 286-2868

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1518685270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5070 EXPOSITION DR APT B417",
            "city": "JOHNSTOWN",
            "state": "CO",
            "postal_code": "805346538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4617 W 20TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806343207",
            "telephone_number": "970-352-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIESE",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0018633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Fax",
            "affiliation": "N",
            "address_1": "4617 W 20th St",
            "city": "Greeley",
            "state": "CO",
            "country_code": "US",
            "postal_code": "806343207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.