Individual provider Active NPI

Catherine Ann Wilt, BS

  • Physical Therapist
  • Canon City, CO
National Provider Identifier
1972847549
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7689 Issued in CO
Practice address
1338 Phay Avenue
Canon City, CO 81212-2302
Phone
(719) 285-2609
Fax
(719) 285-2600
NPI assigned
Nov 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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 7689 CO Primary

Addresses

Primary practice location

1338 Phay Avenue
Canon City, CO 81212-2302

Mailing address

1338 Phay Avenue
Canon City, CO 81212-2302
Phone (719) 285-2609

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
7689COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coal Creek Physical Therapy, LLC Physical Therapist CurrentSince Oct 14, 2024 Accepting new patients
Waldron'S Peak Physical Therapy, P.C. Physical Therapist CurrentSince Jan 1, 2025 Accepting new patients
Coal Creek Diagnostics, LLC PastSince Oct 14, 2024 Accepting new patients

Locations

5387 Manhattan Cir
#100A
Boulder, CO 80303

5387 Manhattan Cir
Ste 100A
Boulder, CO 80303
Phone (303) 499-6818

1216 Arapahoe St
Golden, CO 80401
Phone (303) 279-3728

315 W South Boulder Rd
Ste 100
Louisville, CO 80027
Phone (303) 601-6666

Organizations & group practices 3

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": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1972847549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1338 PHAY AVENUE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122302",
            "telephone_number": "719-285-2609",
            "fax_number": "719-285-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1338 PHAY AVENUE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122302",
            "telephone_number": "719-285-2609",
            "fax_number": "719-285-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILT",
        "first_name": "CATHERINE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-20",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "7689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; 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.