1174586077 NPI number — MRS. DEANN L GERMAN PT CHT

Table of content: MRS. DEANN L GERMAN PT CHT (NPI 1174586077)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174586077 NPI number — MRS. DEANN L GERMAN PT CHT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GERMAN
Provider First Name:
DEANN
Provider Middle Name:
L
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PT CHT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BLUMENTHAL
Provider Other First Name:
DEANN
Provider Other Middle Name:
L
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1174586077
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/31/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
660 GOLDEN RIDGE RD
Provider Second Line Business Mailing Address:
SUITE 250
Provider Business Mailing Address City Name:
GOLDEN
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80401-9541
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-233-1223
Provider Business Mailing Address Fax Number:
303-233-8755

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
660 GOLDEN RIDGE RD
Provider Second Line Business Practice Location Address:
SUITE 250
Provider Business Practice Location Address City Name:
GOLDEN
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80401-9541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-233-1223
Provider Business Practice Location Address Fax Number:
303-233-8755
Provider Enumeration Date:
04/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  2305204407 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251H1200X , with the licence number: 45745 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7575324 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00396601 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4575 . This is a "COLORADO PT LICENSE NUMBER" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 010198518 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 192939 . This is a "BCBS PHYSICAL THERAPY" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 39388867 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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