Organization Active NPI

Muscle Restoration, Inc.

  • Pain Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1669354817
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
MUSCLE RESTORATION, INC.
Practice address
4532 McMurry Ave Unit 204
Fort Collins, CO 80525-8022
Phone
(402) 363-1864
NPI assigned
Jul 21, 2025
Last updated
Jul 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Authorized official

Name
Jonah Otte
Title
Operations Manager
Phone
(970) 449-9757

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X Primary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X

Addresses

Primary practice location

4532 McMurry Ave Unit 204
Fort Collins, CO 80525-8022

Mailing address

4532 McMurry Ave Unit 204
Fort Collins, CO 80525-8022
Phone (402) 363-1864

National Provider Directory

National Provider Directory

Locations

4532 McMurry Ave
Unit 204
Fort Collins, CO 80525
Phone (402) 363-1864

Practitioners & affiliated clinicians

Practitioners 3

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": "1753056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753142400000",
    "number": "1669354817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4532 MCMURRY AVE UNIT 204",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805258022",
            "telephone_number": "402-363-1864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4532 MCMURRY AVE UNIT 204",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805258022",
            "telephone_number": "402-363-1864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSCLE RESTORATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-21",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A",
        "authorized_official_last_name": "OTTE",
        "authorized_official_first_name": "JONAH",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "970-449-9757"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; 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.