NPIMap

Organization Active NPI

Village Physical Therapy, PC

  • Physical Therapist
  • Pueblo, CO
National Provider Identifier
1992825202
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
VILLAGE PHYSICAL THERAPY, PC
Practice address
1209 Paseo del Norte Ste 3
Pueblo, CO 81008-2083
Phone
(719) 569-5691
Fax
(719) 569-5689
NPI assigned
Mar 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Authorized official

Name
Dale Yake, P.T.
Title
Owner-President
Phone
(678) 837-7176

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 1497 CO
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1209 Paseo del Norte Ste 3
Pueblo, CO 81008-2083

Mailing address

PO Box 200880
Dallas, TX 75320-0880
Phone (678) 837-7176

Other practice location 1

1721 Highway 50 West
Ste 210
Pueblo, CO 81008
Phone (719) 577-4104

Other practice location 2

4035A Club Manor Dr Ste 4
Pueblo, CO 81008-2004
Phone (719) 562-0328

Other names 1

  • PT Solutions of Colorado Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110224001001 CO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5496936379 Receives reassigned benefits from 7 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Colorado Springs, CO; Pueblo, CO

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
PT Solutions of Colorado2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4035A Club Manor Dr
#4
Pueblo, CO 81008
Phone (719) 562-0328

Practitioners & affiliated clinicians

Practitioners 10

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": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681948800000",
    "number": "1992825202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200880",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753200880",
            "telephone_number": "678-837-7176",
            "fax_number": "404-777-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 PASEO DEL NORTE STE 3",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082083",
            "telephone_number": "719-569-5691",
            "fax_number": "719-569-5689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1721 Highway 50 West",
            "address_2": "Ste 210",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "81008",
            "country_code": "US",
            "telephone_number": "719-577-4104",
            "fax_number": "719-575-0872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4035A Club Manor Dr Ste 4",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810082004",
            "country_code": "US",
            "telephone_number": "719-562-0328",
            "fax_number": "719-575-0872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VILLAGE PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A",
        "authorized_official_last_name": "YAKE",
        "authorized_official_first_name": "DALE",
        "authorized_official_title_or_position": "OWNER-PRESIDENT",
        "authorized_official_telephone_number": "678-837-7176",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "1497",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PT Solutions of Colorado",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.