Individual provider Active NPI

Sara Jane Smith, PTA

  • Physical Therapy Assistant
  • Denver, CO
National Provider Identifier
1659623122
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
12204 Issued in CO
Practice address
6060 E Iliff Ave
Denver, CO 80222-5721
Phone
(303) 759-4221
NPI assigned
Oct 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 12204 CO Primary

Addresses

Primary practice location

6060 E Iliff Ave
Denver, CO 80222-5721

Mailing address

16455 E Radcliff PL Apt a
Aurora, CO 80015-7096
Phone (720) 624-9462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12204COMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1659623122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16455 E RADCLIFF PL APT A",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800157096",
            "telephone_number": "720-624-9462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6060 E ILIFF AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802225721",
            "telephone_number": "303-759-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SARA",
        "middle_name": "JANE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-09",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "12204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.