Active NPI
Anndrea Burgess, PTA
- Physical Therapy Assistant
- Lakewood, CO
National Provider Identifier
1891211272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA.0014202
- Practice address
- 1685 Eaton St
Lakewood, CO 80214-1628 - Phone
- (303) 232-4405
- NPI assigned
- Aug 17, 2017
- 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 Therapy Assistant | 225200000X | PTA.0014202 | CO | Primary |
Addresses
Primary practice location
1685 Eaton St
Lakewood, CO 80214-1628
Mailing address
3960 W 112TH Ave Unit 203
Westminster, CO 80031-2173
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PTA.0014202 | Other | CO | PTA LICENSE |
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 |
|---|---|---|---|
| PTA.0014202 | CO | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502928000000",
"number": "1891211272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3960 W 112TH AVE UNIT 203",
"city": "WESTMINSTER",
"state": "CO",
"postal_code": "800312173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1685 EATON ST",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802141628",
"telephone_number": "303-232-4405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGESS",
"first_name": "ANNDREA",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-17",
"last_updated": "2017-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CO",
"license": "PTA.0014202",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTA LICENSE",
"identifier": "PTA.0014202",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.