Individual provider Active NPI

Mary White, PT

  • Physical Therapist
  • Evergreen, CO
National Provider Identifier
1528066198
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7572 Issued in CO
Practice address
3045 Whitman Dr.
Evergreen, CO 80439-2364
Phone
(303) 325-5329
Fax
(303) 670-3323
NPI assigned
Jul 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 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 7572 CO Primary

Addresses

Primary practice location

3045 Whitman Dr.
Evergreen, CO 80439-2364

Mailing address

27118 Mountain Park Rd
Evergreen, CO 80439
Phone (303) 325-5329

Other identifiers 1

IdentifierTypeStateIssuer
7572OtherCOPHYSICAL THERAPY LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110616000082 CO Practitioner - Physical Therapist in Private Practice 9739366907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlas Physical Therapy Limited PartnershipGroup PAC ID 9436506698, 26 clinicians

Practice addresses (Care Compare)

2626 E Colfax Ave
Denver, CO 80206-1412
Phone (303) 832-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7572COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlas Physical Therapy Limited Partnership Physical Therapist CurrentSince May 1, 2024 Accepting new patients

Locations

2626 E Colfax Ave
Denver, CO 80206
Phone (303) 382-3700

32135 Castle Ct
Ste 100A
Evergreen, CO 80439
Phone (303) 325-5329

Organizations & group practices 1

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1528066198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27118 MOUNTAIN PARK RD",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "80439",
            "telephone_number": "303-325-5329",
            "fax_number": "303-670-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3045 WHITMAN DR.",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804392364",
            "telephone_number": "303-325-5329",
            "fax_number": "303-670-3323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "7572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "7572",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.