NPIMap

Organization Active NPI

Colorado Spine Therapy, LLC

  • Orthopedic Physical Therapist
  • Denver, CO
National Provider Identifier
1679766984
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
5012 Issued in CO
Legal business name
COLORADO SPINE THERAPY, LLC
Practice address
1385 S Colorado Blvd
Denver, CO 80222-3304
Phone
(303) 842-5614
Fax
(303) 691-1142
NPI assigned
Aug 20, 2007
Last updated
Dec 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Authorized official

Name
Mr. Stefan JH Van Duursen, PT
Title
Owner/Physical Therapist
Phone
(303) 842-5614

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 5012 CO Primary

Addresses

Primary practice location

1385 S Colorado Blvd
Denver, CO 80222-3304

Mailing address

P.O. Box 21150
Flatirons Practice Management
Boulder, CO 80308-4150
Phone (303) 546-9158

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071005000226 CO Part B Supplier - Clinic/Group Practice 6608961677 Receives reassigned benefits from 7 practitioners
Practice locations: Denver, CO

National Provider Directory

National Provider Directory

Locations

1385 S Colorado Blvd
Ste 620
Denver, CO 80222
Phone (303) 691-3733

3900 E Mexico Ave
Denver, CO 80210
Phone (720) 295-3471

3900 E Mexico Ave
Ste 210
Denver, CO 80210
Phone (303) 691-3733

Practitioners & affiliated clinicians

Practitioners 10

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": "1187568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1679766984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 21150",
            "address_2": "FLATIRONS PRACTICE MANAGEMENT",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803084150",
            "telephone_number": "303-546-9158",
            "fax_number": "303-691-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1385 S COLORADO BLVD",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802223304",
            "telephone_number": "303-842-5614",
            "fax_number": "303-691-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO SPINE THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-20",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "VAN DUURSEN",
        "authorized_official_first_name": "STEFAN",
        "authorized_official_middle_name": "JH",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "303-842-5614",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CO",
            "license": "5012",
            "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 Dec 16, 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.