Champion Sports Medicine and Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

7018 Issued in CO

Legal business name

CHAMPION SPORTS MEDICINE AND PHYSICAL THERAPY, LLC

Practice address

1169 S Alkire St
Lakewood, CO 80228-3113

Phone

(720) 295-6098

NPI assigned

May 4, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stuart Anthony Wilson, PT

Title

Owner

Phone

(720) 295-6098

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Elevate Physical Therapy and Coaching, LLC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Scott McLain Wacker, PT, DPT, CSCS

  • Physical Therapist
  • Vail, CO
  • NPI 1700898913
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603324800000",
    "number": "1912955790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1169 S ALKIRE ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802283113",
            "telephone_number": "720-295-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 S ALKIRE ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802283113",
            "telephone_number": "720-295-6098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9948 W Dorado Pl",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "CO",
            "postal_code": "801232317",
            "country_code": "US",
            "telephone_number": "303-520-2599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHAMPION SPORTS MEDICINE AND PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-295-6098",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CO",
            "license": "7018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "452611370",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elevate Physical Therapy and Coaching, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Savannah Francis Chadwell, AGNP-C
• Mary R Chamberlain
• Cayla Chambers, LPC
• Jodi A Chambers, M.D.
• Theresa Chambers
• Allison Chancellor, BCBA
• Chanda Center for Health
• Chanda Center for Health
• Chanda Center for Health
• Chanda Center for Health

• Physical Therapy Clinic/Center in Lakewood, CO
• Providers in Lakewood, CO by specialty
• Physical Therapy Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.

Verify at the official NPI Registry.