Active NPI
Anna Rebecca Mitchell, PT
- Physical Therapist
- Boulder, CO
National Provider Identifier
1811528334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0016790
- Practice address
- 3000 Center Green Dr Ste 110
Boulder, CO 80301-2364 - Phone
- (303) 413-9903
- Fax
- (303) 413-9907
- NPI assigned
- Feb 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 0016790 | CO | Primary |
Addresses
Primary practice location
3000 Center Green Dr Ste 110
Boulder, CO 80301-2364
Mailing address
PO Box 5718
Kalispell, MT 59903-5718
Phone (406) 756-0134
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0016790 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593475200000",
"number": "1811528334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5718",
"city": "KALISPELL",
"state": "MT",
"postal_code": "599035718",
"telephone_number": "406-756-0134",
"fax_number": "406-300-1612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 CENTER GREEN DR STE 110",
"city": "BOULDER",
"state": "CO",
"postal_code": "803012364",
"telephone_number": "303-413-9903",
"fax_number": "303-413-9907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "ANNA",
"middle_name": "REBECCA",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-03",
"last_updated": "2020-06-30",
"certification_date": "2020-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "0016790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.