Organization Active NPI

Crested Butte Physiotherapy, PC

  • Physical Therapy Clinic/Center
  • Crested Butte, CO
National Provider Identifier
1760868319
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
8225 Issued in CO
Legal business name
CRESTED BUTTE PHYSIOTHERAPY, PC
Practice address
505 2ND St
Crested Butte, CO 81224
Phone
(970) 349-2817
Fax
(970) 349-2779
NPI assigned
Aug 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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

Authorized official

Name
Mr. Tim Poppe, PT
Title
President
Phone
(970) 596-0422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 8225 CO Primary

Addresses

Primary practice location

505 2ND St
Crested Butte, CO 81224

Mailing address

PO Box 1014
Crested Butte, CO 81224-1014
Phone (970) 349-2817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160115001704 CO Part B Supplier - Clinic/Group Practice 8426351933 Receives reassigned benefits from 5 practitioners
Practice locations: Crested Butte, CO
O20190529001067 CO DME Supplier - Independently-Practicing Physical Therapist 8426351933 Practice locations: Crested Butte, CO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565308800000",
    "number": "1760868319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1014",
            "city": "CRESTED BUTTE",
            "state": "CO",
            "postal_code": "812241014",
            "telephone_number": "970-349-2817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 2ND ST",
            "city": "CRESTED BUTTE",
            "state": "CO",
            "postal_code": "81224",
            "telephone_number": "970-349-2817",
            "fax_number": "970-349-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTED BUTTE PHYSIOTHERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-05",
        "last_updated": "2019-08-09",
        "status": "A",
        "authorized_official_last_name": "POPPE",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-596-0422",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CO",
            "license": "8225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crested Butte, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; 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.