Active NPI
David Brazeau
- Physical Therapist
- Colorado Springs, CO
National Provider Identifier
1639138233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3043
- Practice address
- 3141 Centennial Blvd
Colorado Springs, CO 80907-4094 - Phone
- (719) 227-4015
- NPI assigned
- Mar 22, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3043 | SC | Primary |
Addresses
Primary practice location
3141 Centennial Blvd
Colorado Springs, CO 80907-4094
Mailing address
1700 Wheeling St
Aurora, CO 80045-7211
Phone (719) 227-4015
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 |
|---|---|---|---|
| 3043 | SC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621814400000",
"number": "1639138233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 WHEELING ST",
"city": "AURORA",
"state": "CO",
"postal_code": "800457211",
"telephone_number": "719-227-4015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3141 CENTENNIAL BLVD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809074094",
"telephone_number": "719-227-4015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAZEAU",
"first_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-22",
"last_updated": "2021-05-24",
"certification_date": "2021-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "3043",
"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 May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.