Individual provider Active NPI

Bradley J Ott, MSPT

  • Physical Therapist
  • Loveland, CO
National Provider Identifier
1568489177
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4299 Issued in CO
Practice address
107 W 29TH St
Suite 100
Loveland, CO 80538-2797
Phone
(970) 663-6142
Fax
(970) 635-3087
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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 4299 CO Primary

Addresses

Primary practice location

107 W 29TH St
Suite 100
Loveland, CO 80538-2797

Mailing address

107 W 29TH St
Suite 100
Loveland, CO 80538-2797
Phone (970) 663-6142

Other identifiers 1

IdentifierTypeStateIssuer
650024198OtherCORR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040304000275 CO Practitioner - Physical Therapist in Private Practice 6103712153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rebound Sports and Physical Therapy P.CGroup PAC ID 0042106098, 21 clinicians

Practice addresses (Care Compare)

107 W 29TH St
Suite 100
Loveland, CO 80538-2200
Phone (970) 663-6142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4299COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rebound Sports & Physical Therapy, P.C. Physical Therapist CurrentSince Feb 10, 1999 Accepting new patients
Performance Physical Therapy & Rehabilitation , PC Physical Therapist PastSince Jun 2, 1998 Accepting new patients

Locations

3500 John F Kennedy Pkwy
Ste 120
Fort Collins, CO 80525
Phone (970) 663-6142

1300 Riverside Ave
Ste 100
Fort Collins, CO 80524
Phone (970) 663-6142

107 W 29th St
Ste 100
Loveland, CO 80538
Phone (970) 663-6142

Organizations & group practices 2

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1568489177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W 29TH ST",
            "address_2": "SUITE 100",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805382797",
            "telephone_number": "970-663-6142",
            "fax_number": "970-635-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W 29TH ST",
            "address_2": "SUITE 100",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805382797",
            "telephone_number": "970-663-6142",
            "fax_number": "970-635-3087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTT",
        "first_name": "BRADLEY",
        "middle_name": "J",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "4299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "650024198",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.