Aspen Physical Therapy LLC
Organization Active NPI Physical Therapist · Afton, WY
NPI 1720186497 · NPPES record last updated Jul 18, 2013
Key facts
- NPI
- 1720186497
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1564 (WY)
- Legal business name
- ASPEN PHYSICAL THERAPY LLC
- Practice address
- 121 North Washington
Afton, WY 83110-1745 - Phone
- (307) 885-4278
- Fax
- (307) 885-4270
- NPI assigned
- Sep 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Chet A Erickson, PT
- Title
- Member
- Phone
- (307) 885-4278
Practitioners 8
-
Jared Andrew Rose, DPT
-
Elizabeth Mae Scherer, PT, DPT
-
Chet Erickson, DPT
-
Claire L Carter, OTR
-
Greg R Burton, PT
-
Kirk R Vanslyke, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051025000636 | WY | Part B Supplier - Clinic/Group Practice | 2466479845 |
Receives reassigned benefits from 6 practitioners Practice locations: Afton, WY; Thayne, WY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | 1564 | WY | Yes |
Addresses
Primary practice location
121 North Washington
Afton, WY 83110-1745
Mailing address
PO Box 1745
121 North Washington
Afton, WY 83110-1745
Phone (307) 885-4278
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 114557600 | Medicaid | WY |
Other providers in Afton, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.