NPIMap

Organization Active NPI

Advanced Spine & Rehabilitation

  • Physical Therapy Clinic/Center
  • Fort Collins, CO
National Provider Identifier
1992790141
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ADVANCED SPINE & REHABILITATION
Practice address
343 W Drake Rd
Ste 102
Fort Collins, CO 80526-6317
Phone
(970) 204-9635
Fax
(970) 204-9730
NPI assigned
Sep 14, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Grant Barclay
Title
Office Manager
Phone
(970) 204-9635

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

343 W Drake Rd
Ste 102
Fort Collins, CO 80526-6317

Mailing address

343 W Drake Rd
Ste 102
Fort Collins, CO 80526-6317
Phone (970) 204-9635

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040303000480 CO Part B Supplier - Clinic/Group Practice 0648167767 Receives reassigned benefits from 8 practitioners
Practice locations: Fort Collins, CO

National Provider Directory

National Provider Directory

Locations

343 W Drake Rd
Ste 102
Fort Collins, CO 80526
Phone (970) 204-9635

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992790141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 W DRAKE RD",
            "address_2": "STE 102",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805266317",
            "telephone_number": "970-204-9635",
            "fax_number": "970-204-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 W DRAKE RD",
            "address_2": "STE 102",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805266317",
            "telephone_number": "970-204-9635",
            "fax_number": "970-204-9730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SPINE & REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARCLAY",
        "authorized_official_first_name": "GRANT",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "970-204-9635",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.