Active NPI
Kayla Dean Bousfield
- Physical Therapist
- Commerce City, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTL.0018606
- Practice address
- 13659 E 104TH Ave Unit 300
Commerce City, CO 80022-9402 - Phone
- (720) 506-5340
- NPI assigned
- Mar 19, 2021
- Last updated
- Dec 23, 2022
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 15369-24 | WI | |
| Physical Therapist | 225100000X | 040-0134255 | VT | |
| Physical Therapist | 225100000X | 28700 | MD | |
| Physical Therapist | 225100000X | PTL.0018606 | CO | Primary |
Addresses
Primary practice location
13659 E 104TH Ave Unit 300
Commerce City, CO 80022-9402
Mailing address
15 Grandview Acres
Glenburn, ME 04401-1038
Phone (207) 478-4858
Other practice location 1
15 Grandview Acres
Glenburn, ME 04401-1038
Phone (207) 478-4858
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221003000555 | CO | Practitioner - Physical Therapist in Private Practice | 6800284779 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTL.0018606 | CO | MD | Physical Therapist |
| 28700 | MD | MD | Physical Therapist |
| 040-0134255 | VT | MD | Physical Therapist |
| 15369-24 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MVP Physical Therapy, LLC | Physical Therapist | Current | Accepting new patients |
| Select Physical Therapy of West Denver Limited Partnership | Current | Accepting new patients | |
| Select Physical Therapy of West Denver Limited Partnership | Past | Accepting new patients |
Locations
13659 E 104th Ave
Ste 300400
Commerce City, CO 80022
Phone (702) 506-5340
13659 E 104th Ave
Unit 300
Commerce City, CO 80022
Phone (720) 506-5340
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba MVP Physical Therapy
- Physical Therapist
- Commerce City, CO
- NPI 1326473141
-
dba Select Physical Therapy
- Physical Therapy Clinic/Center
- Commerce City, CO
- NPI 1659944957
-
dba Select Physical Therapy
- Physical Therapy Clinic/Center
- Westminster, CO
- NPI 1346896081
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671753600000",
"number": "1912583105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 GRANDVIEW ACRES",
"city": "GLENBURN",
"state": "ME",
"postal_code": "044011038",
"telephone_number": "207-478-4858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13659 E 104TH AVE UNIT 300",
"city": "COMMERCE CITY",
"state": "CO",
"postal_code": "800229402",
"telephone_number": "720-506-5340"
}
],
"practiceLocations": [
{
"address_1": "15 Grandview Acres",
"address_purpose": "LOCATION",
"city": "Glenburn",
"state": "ME",
"postal_code": "044011038",
"country_code": "US",
"telephone_number": "207-478-4858",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOUSFIELD",
"first_name": "KAYLA",
"middle_name": "DEAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-19",
"last_updated": "2022-12-23",
"certification_date": "2022-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "15369-24",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VT",
"license": "040-0134255",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "28700",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "PTL.0018606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Commerce City, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.