Evolve Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

8661 Issued in CO

Legal business name

EVOLVE PHYSICAL THERAPY, LLC

Practice address

137 Main St
G-001
Edwards, CO 81632-8118

Phone

(970) 470-2611

NPI assigned

Sep 5, 2008

Organization subpart

No

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

Authorized official

Name

Keri L Bergeron, MSPT

Title

Physical Therapist, Registered Agen

Phone

(970) 470-2611

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220572800000",
    "number": "1942458617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 MAIN ST",
            "address_2": "G-001",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816328118",
            "telephone_number": "970-470-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 MAIN ST",
            "address_2": "G-001",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816328118",
            "telephone_number": "970-470-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-05",
        "last_updated": "2008-09-05",
        "status": "A",
        "authorized_official_last_name": "BERGERON",
        "authorized_official_first_name": "KERI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST, REGISTERED AGEN",
        "authorized_official_telephone_number": "970-470-2611",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CO",
            "license": "8661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "97734543",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carrie Lee Eckenhoff, PT
• Edwards Chiropractic and Acupuncture Center LLC
• Edwards Medical Provider Group
• Endovascular Consultants of Colorado PC
• Heidi Anna Escobar, PHARM.D.
• Frederick C Ewald, M.D.
• Erika Favela
• Monica Katherine Feagler, N.C.C.
• Miranda Maria Filippides, PH.D.
• Annemarie Finn, MS. CCC-SLP

• Physical Therapy Clinic/Center in Edwards, CO
• Providers in Edwards, 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 Sep 5, 2008; 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.