Active NPI
Mary E Ewers-Dennison, OTR, CHT
- Hand Occupational Therapist
- Boulder, CO
National Provider Identifier
1639176407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hand Occupational Therapist
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AA521369 | Other | OTR | |
| 9105000345 | Other | CERTIFIED 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
| License | State | Type | Specialty |
|---|---|---|---|
| 935 | CO | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountaintop Physical Therapy PC | Past | Accepting new patients | |
| Coal Creek Physical Therapy, LLC | Past | 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.
-
- Diagnostic Ultrasound Physician
- Louisville, CO
- NPI 1366941171
-
- Physical Therapist
- Louisville, CO
- NPI 1740238120
-
- Physical Therapy Clinic/Center
- Estes Park, CO
- NPI 1407976558
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.