NPIMap

Organization Active NPI

Thoracic Park Holdings LLC

  • Physical Medicine & Rehabilitation Physician
  • Thornton, CO
National Provider Identifier
1962280289
Registry record updated Mar 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
THORACIC PARK HOLDINGS LLC
Practice address
12720 Colorado Blvd Unit H
Thornton, CO 80241-2823
Phone
(720) 600-0370
NPI assigned
Sep 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2024

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

Authorized official

Name
Christopher Edmundson, PT, DPT
Title
President
Phone
(617) 275-6818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

12720 Colorado Blvd Unit H
Thornton, CO 80241-2823

Mailing address

11169 E I25 Frontage Rd Ste C
Firestone, CO 80504-5211
Phone (720) 600-0370

Other names 2

  • Integral Physical Therapy Doing business as
  • Thoracic Park Holdings Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240515000726 CO Part B Supplier - Clinic/Group Practice 6709295215 Receives reassigned benefits from 2 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Littleton, CO; Thornton, CO; Lone Tree, CO; Lakewood, CO; Frederick, CO; Firestone, CO; Erie, CO

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Thoracic Park Holdings LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710633600000",
    "number": "1962280289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11169 E I25 FRONTAGE RD STE C",
            "city": "FIRESTONE",
            "state": "CO",
            "postal_code": "805045211",
            "telephone_number": "720-600-0370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12720 COLORADO BLVD UNIT H",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802412823",
            "telephone_number": "720-600-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THORACIC PARK HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-18",
        "last_updated": "2024-03-17",
        "certification_date": "2024-03-17",
        "status": "A",
        "authorized_official_last_name": "EDMUNDSON",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-275-6818",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integral Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Thoracic Park Holdings",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2024; 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.

Verify at the official NPI Registry.