Individual provider Active NPI

Vikki L Bayliss, P.T.

  • Physical Therapist
  • Colorado Springs, CO
National Provider Identifier
1720194095
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2003016640 Issued in MO
Practice address
1650 Cochrane Circle
Evans Army Community Hospital
Colorado Springs, CO 80913
Phone
(719) 526-7120
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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.0011928 CO
Physical Therapist 225100000X 2003016640 MO Primary

Addresses

Primary practice location

1650 Cochrane Circle
Evans Army Community Hospital
Colorado Springs, CO 80913

Mailing address

1650 Cochrane Circle
Evans Army Community Hospital
Fort Carson, CO 80913

Other practice location 1

4925 N Nevada Ave
Colorado Springs, CO 80918-8600
Phone (719) 776-3780

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130320000556 CO Practitioner - Physical Therapist in Private Practice 1052381035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centura Ventures, LLCGroup PAC ID 8628989043, 30 clinicians

Practice addresses (Care Compare)

4925 N Nevada Ave
Colorado Sports and Spine Centers
Colorado Springs, CO 80918-8600
Phone (719) 776-3780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0011928COMDPhysical Therapist
2003016640MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Centura Ventures, LLC CurrentSince Jan 1, 2025 Accepting new patients
Centura Ventures, LLC Physical Therapist CurrentSince Jan 1, 2025 Accepting new patients

Locations

17230 Jackson Creek Pkwy
Ste 170
Monument, CO 80132
Phone (719) 571-7080

11960 Lioness Way
Ste 150
Parker, CO 80134
Phone (303) 269-2893

4112 Outlook Blvd
Ste 96
Pueblo, CO 81008
Phone (719) 562-6200

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1720194095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIRCLE",
            "address_2": "EVANS ARMY COMMUNITY HOSPITAL",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "80913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIRCLE",
            "address_2": "EVANS ARMY COMMUNITY HOSPITAL",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80913",
            "telephone_number": "719-526-7120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4925 N Nevada Ave",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809188600",
            "country_code": "US",
            "telephone_number": "719-776-3780",
            "fax_number": "719-776-3781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAYLISS",
        "first_name": "VIKKI",
        "middle_name": "L",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0011928",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2003016640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 31, 2024; 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.