Organization Active NPI

Neuro Logic Rehabilitation and Wellness

  • Physical Therapy Clinic/Center
  • Colorado Springs, CO
National Provider Identifier
1700470168
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
NEURO LOGIC REHABILITATION AND WELLNESS
Practice address
114 Sunbird Cliffs LN
Colorado Springs, CO 80919-8013
Phone
(847) 502-5971
Fax
(719) 691-7994
NPI assigned
Feb 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Authorized official

Name
Ryan MuellerNPI 1073106142
Title
Owner
Phone
(847) 502-5971

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

114 Sunbird Cliffs LN
Colorado Springs, CO 80919-8013

Mailing address

114 Sunbird Cliffs LN
Colorado Springs, CO 80919-8013
Phone (847) 502-5971

Other names 1

  • Neuro Logic Rehabilitation and Wellness Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Workspace

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210309003017 CO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7315353786 Receives reassigned benefits from 3 practitioners
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25501/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

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": "1614211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1700470168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 SUNBIRD CLIFFS LN",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809198013",
            "telephone_number": "847-502-5971",
            "fax_number": "719-691-7994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 SUNBIRD CLIFFS LN",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809198013",
            "telephone_number": "847-502-5971",
            "fax_number": "719-691-7994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO LOGIC REHABILITATION AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-25",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "MUELLER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-502-5971"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Workspace",
            "affiliation": "N",
            "address_1": "114 Sunbird Cliffs Ln",
            "city": "Colorado Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809198013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Neuro Logic Rehabilitation and Wellness",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Neuro Logic Rehabilitation and Wellness",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.