Centura Ventures, LLC
Organization Active NPI Physical Therapy Clinic/Center · Colorado Springs, CO
NPI 1629600754 · NPPES record last updated Dec 21, 2020
Key facts
- NPI
- 1629600754
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- Legal business name
- CENTURA VENTURES, LLC
- Practice address
- 1263 Lake Plaza Dr Ste 210B
Colorado Springs, CO 80906-3564 - Phone
- (719) 776-3350
- Fax
- (719) 776-3374
- NPI assigned
- Feb 6, 2020
- Organization subpart
- No
Authorized official
- Name
- Ms. Debra Carpenter, RN
- Title
- VP, Ambulatory Services
- Phone
- (303) 765-6998
Other NPIs on the same Medicare enrollment 10
Member of 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181221002214 | CO | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 8628989043 |
Receives reassigned benefits from 32 practitioners 10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Woodland Park, CO; Pueblo, CO; Monument, CO; Colorado Springs, CO; Frisco, CO |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | Yes |
Addresses
Primary practice location
1263 Lake Plaza Dr Ste 210B
Colorado Springs, CO 80906-3564
Mailing address
PO Box 801172
Kansas City, MO 64180-1172
Phone (800) 953-0104
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073882197 | Other | OLD NPI | |
| 9000146144 | Medicaid | CO |
Other names
- XCS PT BROADMOOR
- Centura Physical Therapy at Broadmoor
- Colorado Sport and Spine Centers
Other providers in Colorado Springs, CO
- Centro de la Familia
- Centura Home Care, LLC
- Centura Ventures, LLC
- Centura Ventures, LLC
- Centura Ventures, LLC
- Centura Ventures, LLC
- Centura Ventures, LLC
- Centura Ventures, LLC
- Centura Ventures, LLC
- Century Cancer Centers Colorado Springs, PLLC
All providers in Colorado Springs, CO · Physical Therapy Clinic/Center in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.