NPIMap

Organization Active NPI

Edge Rehabilitation & Wellness LLC

  • Physical Therapist
  • Colorado Springs, CO
National Provider Identifier
1770852006
Registry record updated Feb 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
EDGE REHABILITATION & WELLNESS LLC
Practice address
2150 Hollow Brook Dr
Suite 100
Colorado Springs, CO 80918-8413
Phone
(719) 599-5330
Fax
(719) 599-5438
NPI assigned
Dec 15, 2011
Last updated
Feb 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2012

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

Authorized official

Name
Matthew Marchman, PTNPI 1548364706
Title
Owner
Phone
(719) 433-0496

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

2150 Hollow Brook Dr
Suite 100
Colorado Springs, CO 80918-8413

Mailing address

2150 Hollow Brook Dr
Suite 100
Colorado Springs, CO 80918-8413
Phone (719) 599-5330

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120423000783 CO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7911169701 Receives reassigned benefits from 4 practitioners
Practice locations: Colorado Springs, CO; Cripple Creek, CO; Monument, CO; Trinidad, CO

National Provider Directory

National Provider Directory

Locations

1412 N Hancock Ave
Colorado Springs, CO 80903

1504 N Hancock Ave
Colorado Springs, CO 80903
Phone (719) 635-0003

415 W Rockrimmon Blvd
Ste 300
Colorado Springs, CO 80919
Phone (719) 365-6871

6985 Tutt Blvd
Colorado Springs, CO 80923
Phone (719) 550-2884

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1323907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328745600000",
    "number": "1770852006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 HOLLOW BROOK DR",
            "address_2": "SUITE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809188413",
            "telephone_number": "719-599-5330",
            "fax_number": "719-599-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 HOLLOW BROOK DR",
            "address_2": "SUITE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809188413",
            "telephone_number": "719-599-5330",
            "fax_number": "719-599-5438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGE REHABILITATION & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-15",
        "last_updated": "2012-02-09",
        "status": "A",
        "authorized_official_last_name": "MARCHMAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-433-0496",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Feb 9, 2012; 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.