NPIMap

Organization Active NPI

Chuckies Place

  • Physical Therapy Clinic/Center
  • Fountain, CO
National Provider Identifier
1558905349
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 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
Last updated
Nov 5, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Authorized official

Name
Kesti SuggsNPI 1578451043
Title
Owner
Phone
(719) 209-3365

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X
Physical Therapy Clinic/Center 261QP2000X Primary

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572912000000",
    "number": "1558905349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14445 HOLMES RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809083344",
            "telephone_number": "719-209-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8655 KANE RD STE 1",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "808173339",
            "telephone_number": "719-209-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHUCKIES PLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-05",
        "last_updated": "2019-11-05",
        "status": "A",
        "authorized_official_last_name": "SUGGS",
        "authorized_official_first_name": "KESTI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-209-3365"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; 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.