Organization Active NPI

Lyons Physical Therapy Inc

  • Specialist
  • Lyons, CO
National Provider Identifier
1972798874
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
6185 Issued in CO
Legal business name
LYONS PHYSICAL THERAPY INC
Practice address
435 High Street
Lyons, CO 80540
Phone
(303) 823-8813
Fax
(303) 823-2355
NPI assigned
Sep 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Authorized official

Name
Kristina Donohoe
Title
Office Manager
Phone
(303) 823-8813

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 6185 CO Primary

Addresses

Primary practice location

435 High Street
Lyons, CO 80540

Mailing address

PO Box 1960
Lyons, CO 80540-1960
Phone (303) 823-8813

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040909000444 CO Part B Supplier - Clinic/Group Practice 2264408319 Receives reassigned benefits from 1 practitioner
Practice locations: Longmont, CO; Lyons, CO

National Provider Directory

National Provider Directory

Locations

700 Tenacity Dr
Unit 101
Longmont, CO 80504
Phone (303) 776-8003

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610582400000",
    "number": "1972798874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1960",
            "city": "LYONS",
            "state": "CO",
            "postal_code": "805401960",
            "telephone_number": "303-823-8813",
            "fax_number": "303-823-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 HIGH STREET",
            "city": "LYONS",
            "state": "CO",
            "postal_code": "80540",
            "telephone_number": "303-823-8813",
            "fax_number": "303-823-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYONS PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-13",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A",
        "authorized_official_last_name": "DONOHOE",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "303-823-8813"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CO",
            "license": "6185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyons, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.