Individual provider Active NPI

Abigail Jayne Mihulka, PT, DPT

  • Orthopedic Physical Therapist
  • Montrose, CO
National Provider Identifier
1679240766
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
0017891 Issued in CO
Practice address
611 E Star CT Ste B
Montrose, CO 81401-6704
Phone
(702) 249-1646
NPI assigned
Aug 25, 2021
Last updated
Feb 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 0017891 CO Primary

Addresses

Primary practice location

611 E Star CT Ste B
Montrose, CO 81401-6704

Mailing address

611 E Star CT Ste B
Montrose, CO 81401-6704
Phone (970) 249-1646

Other names 1

  • Abigail Jayne Versemann Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230303001149 CO Practitioner - Physical Therapist in Private Practice 7416320916

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0017891COMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
In Motion Hand Therapy Inc Orthopedic CurrentSince Jan 3, 2023 Accepting new patients
Next Level Physical Therapy PC PastSince Oct 17, 2021 Accepting new patients
Montrose Memorial Hospital, Inc PastSince Feb 8, 2023 Accepting new patients
Next Level Physical Therapy PC PastSince Aug 1, 2021 Accepting new patients

Locations

611 East Star Ct
Ste B
Montrose, CO 81401
Phone (970) 249-1646

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1679240766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E STAR CT STE B",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814016704",
            "telephone_number": "970-249-1646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E STAR CT STE B",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814016704",
            "telephone_number": "702-249-1646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIHULKA",
        "first_name": "ABIGAIL",
        "middle_name": "JAYNE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CO",
            "license": "0017891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABIGAIL",
            "last_name": "VERSEMANN",
            "middle_name": "JAYNE",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Montrose, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.