NPIMap

Organization Active NPI

Aspen Physical Therapy LLC

  • Physical Therapist
  • Afton, WY
National Provider Identifier
1720186497
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1564 Issued in 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
Last updated
Jul 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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

Authorized official

Name
Mr. Chet A Erickson, PTNPI 1912089194
Title
Member
Phone
(307) 885-4278

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 Therapist 225100000X 1564 WY Primary

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 1

IdentifierTypeStateIssuer
114557600MedicaidWY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051025000636 WY Part B Supplier - Clinic/Group Practice 2466479845 Receives reassigned benefits from 6 practitioners
Practice locations: Afton, WY; Thayne, WY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374105600000",
    "number": "1720186497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1745",
            "address_2": "121 NORTH WASHINGTON",
            "city": "AFTON",
            "state": "WY",
            "postal_code": "831101745",
            "telephone_number": "307-885-4278",
            "fax_number": "307-885-4270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 NORTH WASHINGTON",
            "city": "AFTON",
            "state": "WY",
            "postal_code": "831101745",
            "telephone_number": "307-885-4278",
            "fax_number": "307-885-4270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASPEN PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-07-18",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "CHET",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "307-885-4278",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "1564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114557600",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Afton, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; 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.