Individual provider Active NPI

Rebecca Lauren Eddings, PT, DPT

  • Physical Therapist
  • Boulder, CO
National Provider Identifier
1972156917
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0016491 Issued in CO
Practice address
777 29TH St Ste 102
Boulder, CO 80303-2316
Phone
(303) 601-7495
Fax
(888) 433-8309
NPI assigned
Jul 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0016491 CO Primary

Addresses

Primary practice location

777 29TH St Ste 102
Boulder, CO 80303-2316

Mailing address

777 29TH St Ste 102
Boulder, CO 80303-2316
Phone (303) 601-7495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0016491COMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1972156917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 29TH ST STE 102",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032316",
            "telephone_number": "303-601-7495",
            "fax_number": "888-433-8309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 29TH ST STE 102",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032316",
            "telephone_number": "303-601-7495",
            "fax_number": "888-433-8309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDDINGS",
        "first_name": "REBECCA",
        "middle_name": "LAUREN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-18",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0016491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; 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.