Individual provider Active NPI

Daniel R Coupe, PT

  • Orthopedic Physical Therapist
  • Pueblo, CO
National Provider Identifier
1962956102
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PTL.0016073 Issued in CO
Practice address
4115 Club Manor Dr
Pueblo, CO 81008
Phone
(719) 568-9790
Fax
(719) 568-9791
NPI assigned
Aug 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PTL.0016073 CO Primary

Addresses

Primary practice location

4115 Club Manor Dr
Pueblo, CO 81008

Mailing address

4115 Club Manor Dr
Pueblo, CO 81008
Phone (719) 568-9790

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190108000703 CO Practitioner - Physical Therapist in Private Practice 3577850742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Massachusetts Medical School, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Physical Therapy and WellnessGroup PAC ID 5991920001, 3 clinicians

Practice addresses (Care Compare)

4115 Club Manor Dr
Pueblo, CO 81008-2014
Phone (719) 568-9790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Physical Therapy and Wellness Physical Therapist CurrentSince Dec 17, 2018 Accepting new patients
Mote Wellness & Rehab Inc PastSince Jun 1, 2009 Accepting new patients

Locations

1080 Eagleridge Blvd
Pueblo, CO 81008
Phone (719) 568-9790

4115 Club Manor Dr
Pueblo, CO 81008
Phone (719) 568-9790

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1962956102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 CLUB MANOR DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81008",
            "telephone_number": "719-568-9790",
            "fax_number": "719-568-9791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 CLUB MANOR DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81008",
            "telephone_number": "719-568-9790",
            "fax_number": "719-568-9791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUPE",
        "first_name": "DANIEL",
        "middle_name": "R",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-04",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CO",
            "license": "PTL.0016073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.