Individual provider Active NPI

Mary E Ewers-Dennison, OTR, CHT

  • Hand Occupational Therapist
  • Boulder, CO
National Provider Identifier
1639176407
Registry record updated Feb 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
Practice address
3000 Center Green Dr
110
Boulder, CO 80301-2364
Phone
(303) 601-6666
Fax
(303) 447-3390
NPI assigned
Jul 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X Primary

Addresses

Primary practice location

3000 Center Green Dr
110
Boulder, CO 80301-2364

Mailing address

3000 Center Green Dr
110
Boulder, CO 80301-2364
Phone (303) 601-6666

Other identifiers 2

IdentifierTypeStateIssuer
AA521369OtherOTR
9105000345OtherCERTIFIED HAND THERAPIST

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
935COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mountaintop Physical Therapy PC PastSince Oct 19, 2011 Accepting new patients
Coal Creek Physical Therapy, LLC PastSince Dec 8, 2003 Accepting new patients
Coal Creek Diagnostics, LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203120000000",
    "number": "1639176407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 CENTER GREEN DR",
            "address_2": "110",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012364",
            "telephone_number": "303-601-6666",
            "fax_number": "303-447-3390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 CENTER GREEN DR",
            "address_2": "110",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012364",
            "telephone_number": "303-601-6666",
            "fax_number": "303-447-3390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWERS-DENNISON",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "OTR, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2008-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTR",
            "identifier": "AA521369",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED HAND THERAPIST",
            "identifier": "9105000345",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2008; 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.