Jeffrey Aaron South, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL.0014420 Issued in CO

Practice address

2150 Stadium Dr
Boulder, CO 80309-0001

Phone

(303) 315-9900

Fax

(303) 315-9902

NPI assigned

Feb 5, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Level Up Wellness and Physical Therapy, Inc.Group PAC ID 0840686093, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Level Up Wellness and Physical Therapy, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Oakland, CA
  • NPI 1710659974

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Terrapin Physical Therapy Inc PC

  • Physical Therapist
  • Monterey, CA
  • NPI 1437215654
  NPD
• Boulder Community Health

  dba Community Medical Associates of BCH

  • Medical Specialty Clinic/Center
  • Boulder, CO
  • NPI 1407685498
  NPD (past)
• Neurorenew Physical Therapy PC

  dba NeuroRenew Physical Therapy & Wellness

  • Neurology Physical Therapist
  • San Francisco, CA
  • NPI 1225928252
  NPD (past)

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

{
    "created_epoch": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510185600000",
    "number": "1649519034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 WESTERN AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012709",
            "telephone_number": "303-315-9900",
            "fax_number": "303-315-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 STADIUM DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803090001",
            "telephone_number": "303-315-9900",
            "fax_number": "303-315-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTH",
        "first_name": "JEFFREY",
        "middle_name": "AARON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-05",
        "last_updated": "2017-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0014420",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "39908",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60505",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Soulma LLC (SoulMa Wellness)
• Soulterra Cousnseling P.L.L.C
• Source Psychiatry, PC
• South Boulder Healing Center PLLC
• South Boulder Pediatric Dentistry
• Teresa Southard, PT
• Southpointe Family Resource Center, P.C.
• Shannon Smith Sovndal
• Spacious Soul Counseling LLC
• Alyssa Marie Spampinato, NONE

• Physical Therapist in Boulder, CO
• Providers in Boulder, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.