Chuckies Place
Organization Active NPI Physical Therapy Clinic/Center · Fountain, CO
NPI 1558905349 · NPPES record last updated Nov 5, 2019
Key facts
- NPI
- 1558905349
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- Legal business name
- CHUCKIES PLACE
- Practice address
- 8655 Kane Rd Ste 1
Fountain, CO 80817-3339 - Phone
- (719) 209-3365
- NPI assigned
- Nov 5, 2019
- Organization subpart
- No
Authorized official
- Name
- Kesti Suggs
- Title
- Owner
- Phone
- (719) 209-3365
Other NPIs on the same Medicare enrollment 1
Practitioners 11
-
Kesti Cordova Suggs, OTR
-
Shaela Hepworth, SLPA
-
Amanda J Huckstep, MPT
-
Mark W Olson, MPT
-
Cindy Stroup, OTR
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190510000608 | CO | Part B Supplier - Clinic/Group Practice | 8224371471 |
Receives reassigned benefits from 6 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Peyton, CO |
National Provider Directory
Locations
13039 Falcon Hwy
Peyton, CO 80831
Phone (719) 209-3365
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist |
225XP0200X | |||
| Physical Therapy Clinic/Center | 261QP2000X | Yes |
Addresses
Primary practice location
8655 Kane Rd Ste 1
Fountain, CO 80817-3339
Mailing address
14445 Holmes Rd
Colorado Springs, CO 80908-3344
Phone (719) 209-3365
Other providers in Fountain, CO
- Catholic Health Initiatives Colorado
- Leslie Katherine Chaffin
- Sydney Ann Chappell
- Jacob A Chavez
- Cheyenne Mountain Modern Dentistry, LLP
- City of Fountain
- Rebecca Lee Claros
- Ashley Collins
- Caitlyn Collins
- Colorado Dental Orthodontist Practice, PLLC
All providers in Fountain, CO · Physical Therapy Clinic/Center in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.