Active NPI
Roger C Rettig, PT
- Physical Therapist
- Broomfield, CO
National Provider Identifier
1639251986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2539
- Practice address
- 300 Nickel St
Suite 6
Broomfield, CO 80020-2097 - Phone
- (303) 460-9129
- Fax
- (303) 469-2324
- NPI assigned
- Oct 19, 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 | 2539 | CO | Primary |
Addresses
Primary practice location
300 Nickel St
Suite 6
Broomfield, CO 80020-2097
Mailing address
300 Nickel St
Ste 6
Broomfield, CO 80020-2097
Phone (303) 460-9123
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326844800000",
"number": "1639251986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 NICKEL ST",
"address_2": "STE 6",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800202097",
"telephone_number": "303-460-9123",
"fax_number": "303-469-2324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 NICKEL ST",
"address_2": "SUITE 6",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800202097",
"telephone_number": "303-460-9129",
"fax_number": "303-469-2324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RETTIG",
"first_name": "ROGER",
"middle_name": "C",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2012-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "2539",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broomfield, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.