Active NPI
Jo Ellen Lied, P.T.
- Pediatric Physical Therapist
- Colorado Springs, CO
National Provider Identifier
1609116185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- Practice address
- 2490 Jenner CT
Colorado Springs, CO 80919-3547 - Phone
- (719) 425-7771
- Fax
- (303) 223-0084
- NPI assigned
- Feb 21, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | Primary |
Addresses
Primary practice location
2490 Jenner CT
Colorado Springs, CO 80919-3547
Mailing address
PO Box 4757
Woodland Park, CO 80866-4757
Phone (719) 660-2675
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2709 | CO | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361404800000",
"number": "1609116185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4757",
"city": "WOODLAND PARK",
"state": "CO",
"postal_code": "808664757",
"telephone_number": "719-660-2675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2490 JENNER CT",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809193547",
"telephone_number": "719-425-7771",
"fax_number": "303-223-0084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIED",
"first_name": "JO",
"middle_name": "ELLEN",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-21",
"last_updated": "2013-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.