Individual provider Active NPI

Kelly Wormald, DPT

  • Physical Therapist
  • Monument, CO
National Provider Identifier
1699605675
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0021281 Issued in CO
Practice address
1840 Woodmoor Dr Ste 106
Monument, CO 80132-9098
Phone
(719) 694-9747
Fax
(719) 694-9832
NPI assigned
May 21, 2026
Last updated
May 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL.0021281 CO Primary

Addresses

Primary practice location

1840 Woodmoor Dr Ste 106
Monument, CO 80132-9098

Mailing address

1650 Lyndon Farm CT Ste 300
Louisville, KY 40223-5005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260608002916 CO Practitioner - Physical Therapist in Private Practice 9436620713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Manual Edge Physical Therapy Specialists LLCGroup PAC ID 5597161125, 11 clinicians

Practice addresses (Care Compare)

1840 Woodmoor Dr
Suite 106
Monument, CO 80132-9098
Phone (719) 653-0450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0021281COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Manual Edge Physical Therapy Specialists LLC Physical Therapist CurrentSince May 27, 2026 Accepting new patients

Locations

1840 Woodmoor Dr
Ste 106
Monument, CO 80132
Phone (719) 653-0450

Organizations & group practices 2

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": "1779321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1699605675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 WOODMOOR DR STE 106",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801329098",
            "telephone_number": "719-694-9747",
            "fax_number": "719-694-9832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORMALD",
        "first_name": "KELLY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-21",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0021281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monument, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.