Individual provider Active NPI

Caitlin Brooke

  • Pediatric Occupational Therapist
  • Louisville, CO
National Provider Identifier
1588216022
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
0006063 Issued in CO
Practice address
165 McCaslin Blvd Unit B
Louisville, CO 80027-9463
Phone
(303) 604-6441
NPI assigned
Jul 15, 2019
Last updated
Oct 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 0006063 CO Primary

Addresses

Primary practice location

165 McCaslin Blvd Unit B
Louisville, CO 80027-9463

Mailing address

6861 Roaring Fork TRL
Boulder, CO 80301-3630

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL WebPT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0006063COMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Growful Pediatric Occupational Therapy LLC. Pediatrics CurrentSince Oct 25, 2020 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1588216022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6861 ROARING FORK TRL",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 MCCASLIN BLVD UNIT B",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800279463",
            "telephone_number": "303-604-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKE",
        "first_name": "CAITLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CO",
            "license": "0006063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "WebPT",
            "affiliation": "N",
            "address_1": "165 McCaslin Blvd Unit B",
            "city": "Louisville",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800279463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.