NPIMap

Organization Active NPI

Advantage Physical Therapy & Wellness, PC

  • Physical Therapist
  • Durango, CO
National Provider Identifier
1790850824
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25-38638-0000 Issued in CO
Legal business name
ADVANTAGE PHYSICAL THERAPY & WELLNESS, PC
Practice address
3600 Main Ave Ste a
Durango, CO 81301-4031
Phone
(970) 259-7829
Fax
(970) 259-9411
NPI assigned
Nov 22, 2006
Last updated
Jun 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Mr. Michael Testa, MSPTNPI 1942291141
Title
President and Physical Therapist
Phone
(970) 259-7829

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 25-38638-0000 CO Primary

Addresses

Primary practice location

3600 Main Ave Ste a
Durango, CO 81301-4031

Mailing address

3600 Main Ave Ste a
Durango, CO 81301-4031
Phone (970) 259-7829

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040709001298 CO Part B Supplier - Clinic/Group Practice 1052399649 Receives reassigned benefits from 12 practitioners
Practice locations: Durango, CO

National Provider Directory

National Provider Directory
Tax ID family
Advantage Physical Therapy Welness PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

125 Mercado St
Ste 115
Durango, CO 81301
Phone (970) 259-7829

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1790850824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 MAIN AVE STE A",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813014031",
            "telephone_number": "970-259-7829",
            "fax_number": "970-259-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 MAIN AVE STE A",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813014031",
            "telephone_number": "970-259-7829",
            "fax_number": "970-259-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE PHYSICAL THERAPY & WELLNESS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "TESTA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT AND PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "970-259-7829",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "25-38638-0000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.