Colorado Occupational and Lymphedema Therapy LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

OT.0002493 Issued in CO

Legal business name

COLORADO OCCUPATIONAL AND LYMPHEDEMA THERAPY LLC

Practice address

2624 Espinoza St
Trinidad, CO 81082-3913

Phone

(419) 508-3996

NPI assigned

Nov 14, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Michael J E Fyffe

Title

Otr/L

Phone

(419) 508-3996

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479081600000",
    "number": "1922540558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 ESPINOZA ST",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810823913",
            "telephone_number": "419-508-3996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2624 ESPINOZA ST",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810823913",
            "telephone_number": "419-508-3996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO OCCUPATIONAL AND LYMPHEDEMA THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-14",
        "last_updated": "2016-11-14",
        "status": "A",
        "authorized_official_last_name": "FYFFE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J E",
        "authorized_official_title_or_position": "OTR/L",
        "authorized_official_telephone_number": "419-508-3996",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "CO",
            "license": "OT.0002493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; 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.