Active NPI
Paulette Kimberly Larue, PHYSICAL THERAPIST
- Pediatric Physical Therapist
- Colorado Springs, CO
National Provider Identifier
1801868971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 6284
- Practice address
- 6385 Corporate Dr
Colorado Springs, CO 80919-5901 - Phone
- (828) 670-8056
- Fax
- (828) 670-8057
- NPI assigned
- Feb 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 6284 | NC | Primary |
| Physical Therapist | 225100000X | 6284 | NC | |
| Physical Therapist | 225100000X |
Addresses
Primary practice location
6385 Corporate Dr
Colorado Springs, CO 80919-5901
Mailing address
6385 Corporate Dr
Colorado Springs, CO 80919-5901
Phone (719) 380-1100
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7211608 | Medicaid | NC | |
| 9370547 | Other | PHCS | |
| 079HJ | Other | NC | BCBS |
| D7567 | Other | NC | MEDCOST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6284 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698451200000",
"number": "1801868971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6385 CORPORATE DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809195901",
"telephone_number": "719-380-1100",
"fax_number": "828-670-8057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6385 CORPORATE DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809195901",
"telephone_number": "828-670-8056",
"fax_number": "828-670-8057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARUE",
"first_name": "PAULETTE",
"middle_name": "KIMBERLY",
"name_prefix": "Ms.",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-03",
"last_updated": "2023-10-28",
"certification_date": "2023-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "NC",
"license": "6284",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "6284",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7211608",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS",
"identifier": "9370547",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "079HJ",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "D7567",
"state": "NC"
}
],
"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 Oct 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.