NPIMap

Organization Active NPI

Thoracic Park Holdings LLC

Doing business as Integral Physical Therapy

  • Physical Medicine & Rehabilitation Physician
  • Firestone, CO
National Provider Identifier
1659159044
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
THORACIC PARK HOLDINGS LLC
Doing business as
Integral Physical Therapy
Thoracic Park Holdings
Practice address
11169 E I25 Frontage Rd Ste C
Firestone, CO 80504-5211
Phone
(720) 600-0370
NPI assigned
Sep 18, 2023
Last updated
Oct 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Authorized official

Name
Christopher Edmundson, PT, DPTNPI 1235314584
Title
Member
Phone
(617) 275-6818

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 Medicine & Rehabilitation Physician 208100000X Primary

Addresses

Primary practice location

11169 E I25 Frontage Rd Ste C
Firestone, CO 80504-5211

Mailing address

11169 E I25 Frontage Rd Ste C
Firestone, CO 80504-5211

Other names 2

  • Integral Physical Therapy Doing business as
  • Thoracic Park Holdings Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240515000726 CO Part B Supplier - Clinic/Group Practice 6709295215 Receives reassigned benefits from 2 practitioners
7 other NPIs on this enrollment
Practice locations: Littleton, CO; Thornton, CO; Lone Tree, CO; Lakewood, CO; Frederick, CO; Firestone, CO; Erie, CO

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Thoracic Park Holdings LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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": "1694995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1659159044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11169 E I25 FRONTAGE RD STE C",
            "city": "FIRESTONE",
            "state": "CO",
            "postal_code": "805045211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11169 E I25 FRONTAGE RD STE C",
            "city": "FIRESTONE",
            "state": "CO",
            "postal_code": "805045211",
            "telephone_number": "720-600-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THORACIC PARK HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-18",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "EDMUNDSON",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "617-275-6818",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integral Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Thoracic Park Holdings",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Firestone, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.