Organization Active NPI

High Desert Physical Therapy LLC

  • Physical Therapist
  • Cortez, CO
National Provider Identifier
1649760331
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
HIGH DESERT PHYSICAL THERAPY LLC
Practice address
111 N Park St Ste B
Cortez, CO 81321
Phone
(920) 277-5809
NPI assigned
May 17, 2018
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Megan Flesch, PT, DPTNPI 1942612692
Title
Owner/Physical Therapist
Phone
(920) 277-5809

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20180801000545 CO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3476801846 Receives reassigned benefits from 3 practitioners
Practice locations: Cortez, CO

National Provider Directory

National Provider Directory

Locations

111 N Park St
Cortez, CO 81321
Phone (970) 564-8730

111 N Park St
#B
Cortez, CO 81321
Phone (970) 516-1600

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X CO Primary

Addresses

NPPES NPI Registry

Primary practice location

111 N Park St Ste B
Cortez, CO 81321

Mailing address

111 N Park St Ste B
Cortez, CO 81321-3340
Phone (920) 277-5809

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
55180876MedicaidCO

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 16, 2018.

{
    "created_epoch": "1526515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1649760331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N PARK ST STE B",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813213340",
            "telephone_number": "920-277-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N PARK ST STE B",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "81321",
            "telephone_number": "920-277-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGH DESERT PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-17",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "FLESCH",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "920-277-5809",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55180876",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortez, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.