Alyssa Charbonneau, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL.0017629 Issued in CO

Practice address

2001 S Shields St Ste A1
Fort Collins, CO 80526-1828

Phone

(970) 797-2431

Fax

(970) 797-2509

NPI assigned

Jun 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Momentum Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Fort Collins, CO
  • NPI 1720094329
  Medicare reassignment NPD
• Enhanced Physical Therapy

  • Physical Therapist
  • Glendale, AZ
  • NPI 1013963487
  NPD
• Momentum Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Greeley, CO
  • NPI 1306921739
  NPD (past)

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1558856005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S SHIELDS ST STE A1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805261828",
            "telephone_number": "970-797-2431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S SHIELDS ST STE A1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805261828",
            "telephone_number": "970-797-2431",
            "fax_number": "970-797-2509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18301 N 79th Ave Ste B122",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853088469",
            "country_code": "US",
            "telephone_number": "623-486-3333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARBONNEAU",
        "first_name": "ALYSSA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-30116",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0017629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Nicole Chapman, PTA
• Jeffrey K Chapman, MD
• Karin Chapman, CMT
• Robyn Chapman
• Nathaniel S Chappelle, MD
• Brandon Joseph Charbonneau, OD
• Jacqueline Michelle Charbonneau, LCSW
• Jessie Charbonneau
• Jean Charbonnet, CNIM
• Phaedra Charles

• Physical Therapist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.