Individual provider Active NPI

Carrie L Schneider, PT

  • Sports Physical Therapist
  • Boulder, CO
National Provider Identifier
1699946285
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
License
PTL.0003043 Issued in CO
Practice address
2150 Stadium Dr
Boulder, CO 80309-0001
Phone
(303) 315-9900
Fax
(303) 315-9902
NPI assigned
Mar 21, 2008
Last updated
Jun 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL.0003043 CO
Sports Physical Therapist 2251S0007X PTL.0003043 CO Primary

Addresses

Primary practice location

2150 Stadium Dr
Boulder, CO 80309-0001

Mailing address

5450 Western Ave
Boulder, CO 80301-2709
Phone (303) 415-4770

Other identifiers 1

IdentifierTypeStateIssuer
95152709MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121023000578 CO Practitioner - Physical Therapist in Private Practice 3577713809 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0003043COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy of Boulder Physical Therapist CurrentSince Dec 18, 2016 Accepting new patients
Boulder Community Health Past Accepting new patients
Bayada Home Health Care, Inc. PastSince Apr 20, 2017 Accepting new patients

Locations

3020 Carbon Pl
Ste 330
Boulder, CO 80301
Phone (303) 938-1141

3020 Carbon Pl
Boulder, CO 80301
Phone (303) 938-1141

806 S Public Rd
Ste 300
Lafayette, CO 80026
Phone (720) 406-7408

275 S Main St
Ste 201
Longmont, CO 80501
Phone (303) 682-2440

Organizations & group practices 3

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": "1206057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1699946285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 WESTERN AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012709",
            "telephone_number": "303-415-4770",
            "fax_number": "303-415-4769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 STADIUM DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803090001",
            "telephone_number": "303-315-9900",
            "fax_number": "303-315-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "CARRIE",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-21",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0003043",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "CO",
            "license": "PTL.0003043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95152709",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; 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.