11-11 Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

11-11 PHYSICAL THERAPY, LLC

Practice address

6851 S Holly Cir Ste 100
Centennial, CO 80112-1040

Phone

(303) 771-3745

Fax

(303) 771-3728

NPI assigned

Oct 15, 2018

Last updated

Nov 7, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carrie Anne Cooper, PTNPI 1447204037

Title

Owner

Phone

(303) 471-6212

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carrie A Cooper, PT, MSPT

  • Physical Therapist
  • Centennial, CO
  • NPI 1447204037
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541548800000",
    "number": "1528534740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6851 S HOLLY CIR STE 100",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121040",
            "telephone_number": "303-771-3745",
            "fax_number": "303-771-3728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6851 S HOLLY CIR STE 100",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121040",
            "telephone_number": "303-771-3745",
            "fax_number": "303-771-3728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "11-11 PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-15",
        "last_updated": "2018-11-07",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-471-6212",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 11TH Hour Trauma Retreat, LLC
• 180 Medical, Inc.
• 1918 Winter Street Operating Co LLC (Safeway Pharmacy #0008)
• 1St Allergy and Asthma Center
• 1St Allergy, Asthma and Pediatrics Too, Inc. (Immunoe Health Centers)

• Physical Therapy Clinic/Center in Centennial, CO
• Providers in Centennial, CO by specialty
• Physical Therapy Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.