NPIMap

Organization Active NPI

Village Physical Therapy, PC

  • Physical Therapy Clinic/Center
  • Castle Rock, CO
National Provider Identifier
1720447964
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
1497 Issued in CO
Legal business name
VILLAGE PHYSICAL THERAPY, PC
Practice address
801 S Perry St
Suite105
Castle Rock, CO 80104-1924
Phone
(719) 577-4104
Fax
(719) 575-0872
NPI assigned
Feb 16, 2016
Last updated
Feb 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Authorized official

Name
Michele Childs, PT
Title
President/Physical Therapist
Phone
(719) 577-4104

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 1497 CO Primary

Addresses

Primary practice location

801 S Perry St
Suite105
Castle Rock, CO 80104-1924

Mailing address

545 E Pikes Peak Ave
Suite 320
Colorado Springs, CO 80903-3637
Phone (719) 577-4104

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110224001001 CO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5496936379 Receives reassigned benefits from 7 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Colorado Springs, CO; Pueblo, CO

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1455580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455580800000",
    "number": "1720447964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 E PIKES PEAK AVE",
            "address_2": "SUITE 320",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809033637",
            "telephone_number": "719-577-4104",
            "fax_number": "719-575-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S PERRY ST",
            "address_2": "SUITE105",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801041924",
            "telephone_number": "719-577-4104",
            "fax_number": "719-575-0872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-16",
        "last_updated": "2016-02-16",
        "status": "A",
        "authorized_official_last_name": "CHILDS",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "719-577-4104",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CO",
            "license": "1497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.