Individual provider Active NPI

Jennifer Ann Knox

  • Physical Therapy Clinic/Center
  • Longmont, CO
National Provider Identifier
1649575184
Registry record updated Jan 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Practice address
1551 Professional LN
Suite 145
Longmont, CO 80501-6972
Phone
(720) 494-3290
Fax
(720) 494-3294
NPI assigned
Jan 13, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2011

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotic Fitter 225000000X CO
Massage Therapist 225700000X CO
Occupational Therapist 225X00000X CO
Hand Occupational Therapist 225XH1200X CO
Physical Therapy Clinic/Center 261QP2000X CO Primary

Addresses

Primary practice location

1551 Professional LN
Suite 145
Longmont, CO 80501-6972

Mailing address

1551 Professional la
Suite 145
Longmont, CO 80501
Phone (720) 494-3290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120927000584 CO Practitioner - Physical Therapist in Private Practice 4587813043 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Physical Therapy LLC Physical Therapy CurrentSince Jan 7, 2017 Accepting new patients

Locations

5350 Manhattan Cir
Ste 100
Boulder, CO 80303
Phone (303) 378-9727

5353 Manhattan Cir
Ste 103
Boulder, CO 80303
Phone (303) 378-9727

Organizations & group practices 1

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": "1294876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294876800000",
    "number": "1649575184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 PROFESSIONAL LA",
            "address_2": "SUITE 145",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "80501",
            "telephone_number": "720-494-3290",
            "fax_number": "720-494-3294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 PROFESSIONAL LN",
            "address_2": "SUITE 145",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016972",
            "telephone_number": "720-494-3290",
            "fax_number": "720-494-3294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOX",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-13",
        "last_updated": "2011-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": "CO",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CO",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.