Active NPI
Jacqueline Jean McGough, PHYSICAL THERAPIST
- Physical Therapist
- Fort Collins, CO
National Provider Identifier
1861672453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1774
- Practice address
- 1045 Robertson St
Fort Collins, CO 80524-3926 - Phone
- (970) 493-6667
- Fax
- (970) 493-8016
- NPI assigned
- Nov 12, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1774 | CO | Primary |
Addresses
Primary practice location
1045 Robertson St
Fort Collins, CO 80524-3926
Mailing address
1045 Robertson St
Fort Collins, CO 80524-3926
Phone (970) 493-6667
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194825600000",
"number": "1861672453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1045 ROBERTSON ST",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805243926",
"telephone_number": "970-493-6667",
"fax_number": "970-493-8016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1045 ROBERTSON ST",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805243926",
"telephone_number": "970-493-6667",
"fax_number": "970-493-8016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGOUGH",
"first_name": "JACQUELINE",
"middle_name": "JEAN",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-12",
"last_updated": "2007-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "1774",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.