Individual provider Active NPI

Robert Drenning, MSPT

  • Physical Therapist
  • Broomfield, CO
National Provider Identifier
1801837521
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3988 Issued in NM
Practice address
54 Garden Ctr
Broomfield, CO 80020-1730
Phone
(303) 465-0084
Fax
(303) 465-0684
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

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 10565 CO
Physical Therapist 225100000X 3988 NM Primary

Addresses

Primary practice location

54 Garden Ctr
Broomfield, CO 80020-1730

Mailing address

1398 Weimer Rd
Suite 203
Taos, NM 87571-6397
Phone (575) 737-0304

Other identifiers 1

IdentifierTypeStateIssuer
0713830MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191210002654 UT Practitioner - Physical Therapist in Private Practice 5092718007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Boston University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wasatch Therapy IncGroup PAC ID 3476524760, 10 clinicians

Practice addresses (Care Compare)

42 N 650
Suite a
Farmington, UT 84025-2603
Phone (801) 447-9627

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3988NMMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wasatch Therapy Inc CurrentSince Oct 14, 2019 Accepting new patients
Wasatch Therapy Inc Physical Therapist CurrentSince Oct 14, 2019 Accepting new patients
Physical Therapy Innovations, Inc Physical Therapist PastSince Apr 17, 2002 Accepting new patients

Locations

42 N 650 W
Farmington, UT 84025

42 N 650 W
Ste A
Farmington, UT 84025
Phone (801) 447-9627

5349 Adams Avenue Pkwy
Ste A
Washington Tr, UT 84405
Phone (801) 479-9865

Organizations & group practices 3

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320364800000",
    "number": "1801837521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1398 WEIMER RD",
            "address_2": "SUITE 203",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716397",
            "telephone_number": "575-737-0304",
            "fax_number": "575-737-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 GARDEN CTR",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800201730",
            "telephone_number": "303-465-0084",
            "fax_number": "303-465-0684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRENNING",
        "first_name": "ROBERT",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2011-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "10565",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "3988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0713830",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; 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.