NPI 1205121043 · Physical Therapist in Private Practice · Anthem
Strong multi-source corroboration of active practice across 3 carrier networks with confirmed Colorado DORA license.
NPPES
CENTENNIAL, 80112
Freshness: Unknown
Network Status
Listed with 3 carriers
DORA License
Active
Medicare
Non-Medicare specialty
70 beneficiaries
$55,918.77 total payment
Specialty: Physical Therapist in Private Practice
Care Compare
Address mismatch with NPPES
PECOS Enrollment
Medicare enrolled
Active NPI with specialty classification
Active Colorado DORA license confirmed
Active Medicare billing confirmed
Single address source (NPPES)
Limited carrier network presence
3 networks across 2 carriers
Disclaimer: This analysis uses publicly available federal and state data sources. It does not constitute a determination of provider status or network participation. Contact the provider or health plan directly to verify current status.