NPIMap

Organization Active NPI

Back to Action Physical Therapy

Doing business as Back to Action Physical Therapy, LLC

  • Physical Therapist
  • Lafayette, CO
National Provider Identifier
1609941434
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
BACK TO ACTION PHYSICAL THERAPY
Doing business as
Back to Action Physical Therapy, LLC
Practice address
150 Old Laramie TRL E
Ste 100
Lafayette, CO 80026-7018
Phone
(303) 665-8747
Fax
(303) 926-0184
NPI assigned
Nov 21, 2006
Last updated
Apr 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Authorized official

Name
Mrs. Debra June McKrola, MSPTNPI 1699840421
Title
Member
Phone
(303) 665-8747

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

150 Old Laramie TRL E
Ste 100
Lafayette, CO 80026-7018

Mailing address

150 Old Laramie TRL E
Ste 100
Lafayette, CO 80026-7018
Phone (303) 665-8747

Other practice location 1

1336 Hecla Dr
Louisville, CO 80027-3804
Phone (303) 867-6397

Other names 1

  • Back to Action Physical Therapy, LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040330001435 CO Part B Supplier - Clinic/Group Practice 8426040643 Receives reassigned benefits from 8 practitioners
Practice locations: Lafayette, CO

National Provider Directory

National Provider Directory

Locations

150 Old Laramie Trl
Unit 100
Lafayette, CO 80026
Phone (303) 665-8747

511 Crossing Dr
Ste 100
Lafayette, CO 80026
Phone (303) 664-9165

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554336000000",
    "number": "1609941434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 OLD LARAMIE TRL E",
            "address_2": "STE 100",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800267018",
            "telephone_number": "303-665-8747",
            "fax_number": "303-926-0184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 OLD LARAMIE TRL E",
            "address_2": "STE 100",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800267018",
            "telephone_number": "303-665-8747",
            "fax_number": "303-926-0184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1336 Hecla Dr",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "CO",
            "postal_code": "800273804",
            "country_code": "US",
            "telephone_number": "303-867-6397",
            "fax_number": "303-867-6397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BACK TO ACTION PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2019-04-04",
        "status": "A",
        "authorized_official_last_name": "MCKROLA",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "JUNE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "303-665-8747",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back to Action Physical Therapy, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Back to Action Physical Therapy, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.