Individual provider Active NPI

Elizabeth A Dessner, P.T.

  • Physical Therapist
  • Fort Collins, CO
National Provider Identifier
1629047691
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0014563 Issued in CO
Practice address
5602 Scarlet Ibis LN
Fort Collins, CO 80525-7147
Phone
(563) 260-1156
NPI assigned
Mar 14, 2006
Last updated
Dec 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 02605 IA
Physical Therapist 225100000X PTL.0014563 CO Primary

Addresses

Primary practice location

5602 Scarlet Ibis LN
Fort Collins, CO 80525-7147

Mailing address

5602 Scarlet Ibis LN
Fort Collins, CO 80525-7147
Phone (563) 260-1156

Other practice location 1

400 Ovesen Dr
Wilton, IA 52778
Phone (563) 732-4317

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170522000373 CO Practitioner - Physical Therapist in Private Practice 9436145653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wanda Simmons Physical Therapy PCGroup PAC ID 8820236839, 3 clinicians

Practice addresses (Care Compare)

1136 E Stuart St
2120 Balance Center
Fort Collins, CO 80525-1197
Phone (970) 492-5161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wanda Simmons Physical Therapy, P.C. Physical Therapist CurrentSince Apr 18, 2024 Accepting new patients
Colorado in Motion LLC Physical Therapist CurrentSince Apr 20, 2021 Accepting new patients
Rock Valley Therapy Services, PC PastSince May 1, 2010 Accepting new patients

Locations

1136 E Stuart St
Ste 2120
Fort Collins, CO 80525
Phone (970) 302-4322

1555 Main St
Unit A4
Windsor, CO 80550
Phone (970) 674-9675

Organizations & group practices 4

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1629047691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5602 SCARLET IBIS LN",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805257147",
            "telephone_number": "563-260-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5602 SCARLET IBIS LN",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805257147",
            "telephone_number": "563-260-1156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Ovesen Dr",
            "address_purpose": "LOCATION",
            "city": "Wilton",
            "state": "IA",
            "postal_code": "52778",
            "country_code": "US",
            "telephone_number": "563-732-4317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESSNER",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "02605",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0014563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; 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.