Evergreen Physical Therapy Specialists, PC
Organization Active NPI Orthopedic Physical Therapist · Evergreen, CO
NPI 1801849641 · NPPES record last updated Aug 26, 2018
Key facts
- NPI
- 1801849641
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopedic Physical Therapist 2251X0800X
- Legal business name
- EVERGREEN PHYSICAL THERAPY SPECIALISTS, PC
- Practice address
- 30940 Stagecoach Blvd
Suite E110
Evergreen, CO 80439 - Phone
- (303) 674-1594
- NPI assigned
- May 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Patricia McCord, PT
- Title
- Co-Owner
- Phone
- (303) 674-1594
Practitioners 8
-
Alexis Keeney, DPT
-
John Ruff May, PT, DPT
-
Patricia A. McCord, PT, FAAOMPT
-
Amy Brand, MPT
-
Molly Marie Plasha, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050808001254 | CO | Part B Supplier - Clinic/Group Practice | 7113956327 |
Receives reassigned benefits from 5 practitioners Practice locations: Evergreen, CO |
National Provider Directory
Locations
30940 Stagecoach Blvd
Ste E110
Evergreen, CO 80439
Phone (303) 674-1594
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist |
2251X0800X | Yes |
Addresses
Primary practice location
30940 Stagecoach Blvd
Suite E110
Evergreen, CO 80439
Mailing address
30940 Stagecoach Blvd
Suite E110
Evergreen, CO 80439-7984
Phone (303) 674-1594
Other providers in Evergreen, CO
- Evergreen Medical Acupuncture LLC
- Evergreen Operations, LLC
- Evergreen Oral and Maxillofacial Surgery
- Evergreen Pathways Counseling, LLC
- Evergreen Pediatrics, LLC
- Evergreen Psychotherapy Center
- Evergreen Spine and Sports Medicine LLC
- Evergreen Therapeutic Massage LLC
- Evergreen Vision Clinic, PC
- Fabled Counseling
All providers in Evergreen, CO · Orthopedic Physical Therapist in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.