Organization Active NPI

Conifer Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Conifer, CO
National Provider Identifier
1659009744
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
CONIFER PHYSICAL THERAPY LLC
Practice address
25577 Conifer Rd Unit 125
Conifer, CO 80433-9068
Phone
(303) 838-7444
NPI assigned
Aug 8, 2022
Last updated
Aug 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Authorized official

Name
Timothy Jordan Gotshall, DPTNPI 1518468263
Title
Physical Therapist
Phone
(423) 598-8686

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

25577 Conifer Rd Unit 125
Conifer, CO 80433-9068

Mailing address

25577 Conifer Rd Unit 125
Conifer, CO 80433-9068
Phone (303) 838-7444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221017000049 CO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3779959747 Receives reassigned benefits from 4 practitioners
Practice locations: Conifer, CO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659916800000",
    "number": "1659009744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25577 CONIFER RD UNIT 125",
            "city": "CONIFER",
            "state": "CO",
            "postal_code": "804339068",
            "telephone_number": "303-838-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25577 CONIFER RD UNIT 125",
            "city": "CONIFER",
            "state": "CO",
            "postal_code": "804339068",
            "telephone_number": "303-838-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONIFER PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A",
        "authorized_official_last_name": "GOTSHALL",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "JORDAN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "423-598-8686",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conifer, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.