Refined Form Physical Therapy, PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

REFINED FORM PHYSICAL THERAPY, PLLC

Practice address

3704 Carefree Way
Crestone, CO 81131-0404

Phone

(360) 713-7938

NPI assigned

Jul 13, 2022

Organization subpart

No

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

Authorized official

Name

Jennifer Walkowski, DPT

Title

Owner / Founder

Phone

(719) 204-3434

Specialties & licenses 1

Addresses

Electronic endpoints 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26915/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679443200000",
    "number": "1619601978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 404",
            "city": "CRESTONE",
            "state": "CO",
            "postal_code": "811310404",
            "telephone_number": "719-204-3434",
            "fax_number": "833-464-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3704 CAREFREE WAY",
            "city": "CRESTONE",
            "state": "CO",
            "postal_code": "811310404",
            "telephone_number": "360-713-7938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REFINED FORM PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-13",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A",
        "authorized_official_last_name": "WALKOWSKI",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER / FOUNDER",
        "authorized_official_telephone_number": "719-204-3434",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jenn@refinedformpt.com",
            "affiliation": "N",
            "address_1": "3704 Carefree Way",
            "city": "Crestone",
            "state": "CO",
            "country_code": "US",
            "postal_code": "811310404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Debra Anne Irizarry, MD
• Teresa D. Keller, MA
• Life'S Hope Therapeutic Services PLLC
• Remy Olson
• Shawn Quick, FNP
• Philip Aaron Schechter, MD
• James Michael Sheeran, M.A., L.P.C.
• Jeanine Ten Broeck, LPC
• Jennifer Elaine Walkowski, DPT
• Kathleen Marie Willow, L.M.T.

• All providers in Crestone, CO
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; 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.