Individual provider Active NPI

Brad A Fenter, DPT

  • Physical Therapist
  • Grand Junction, CO
National Provider Identifier
1992363634
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0016424 Issued in CO
Practice address
3150 N 12TH St
Grand Junction, CO 81506-2863
Phone
(970) 241-5856
Fax
(970) 241-8599
NPI assigned
May 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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 PTL.0016424 CO Primary

Addresses

Primary practice location

3150 N 12TH St
Grand Junction, CO 81506-2863

Mailing address

PO Box 10700
Grand Junction, CO 81502-5517
Phone (970) 254-2642

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190701000845 CO Practitioner - Physical Therapist in Private Practice 4284968983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care Partners IncGroup PAC ID 7810893161, 58 clinicians

Practice addresses (Care Compare)

3150 N 12TH St
Grand Junction, CO 81506-2863
Phone (970) 245-1220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0016424COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Partners, Inc. Physical Therapist CurrentSince Jun 10, 2019 Accepting new patients
Primary Care Partners, Inc. CurrentSince Jun 10, 2019 Accepting new patients
Primary Care Partners, Inc. Past Accepting new patients

Locations

3150 N 12th St
Grand Junction, CO 81506
Phone (970) 243-5437

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": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1992363634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10700",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815025517",
            "telephone_number": "970-254-2642",
            "fax_number": "970-254-2637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 N 12TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815062863",
            "telephone_number": "970-241-5856",
            "fax_number": "970-241-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENTER",
        "first_name": "BRAD",
        "middle_name": "A",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-29",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0016424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.