Individual provider Active NPI

Anthony O'Donnell

  • Physical Therapist
  • Colorado Springs, CO
National Provider Identifier
1558046474
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19169 Issued in CO
Practice address
1625 Medical Center PT Ste 180
Colorado Springs, CO 80907-5798
Phone
(719) 344-9497
NPI assigned
Jun 19, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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 19169 CO Primary

Addresses

Primary practice location

1625 Medical Center PT Ste 180
Colorado Springs, CO 80907-5798

Mailing address

277 Bluet St
Colorado Springs, CO 80916-1472
Phone (719) 357-3594

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230809001024 CO Practitioner - Physical Therapist in Private Practice 3274995154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Creighton University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phenix Therapies, LLCGroup PAC ID 0345556502, 16 clinicians

Practice addresses (Care Compare)

1625 Medical Ctr PT
Suite 180
Colorado Springs, CO 80907-5798
Phone (719) 344-9497

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Phenix Therapies, LLC Physical Therapist CurrentSince Jun 26, 2023 Accepting new patients

Locations

1625 Medical Center Pt
Ste 180
Colorado Springs, CO 80907
Phone (719) 344-9497

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": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1558046474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 BLUET ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809161472",
            "telephone_number": "719-357-3594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 MEDICAL CENTER PT STE 180",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809075798",
            "telephone_number": "719-344-9497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "19169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; 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.