CANON CITY PHYSIOTHERAPY INC – Physical Therapist, NPI 1154477065

CANON CITY PHYSIOTHERAPY INC is a healthcare provider. based in Canon city, Colorado. specializing in Physical Therapist. The organization holds a License No. 6141 (CO). The NPI Number for CANON CITY PHYSIOTHERAPY INC is 1154477065

Main info

Organization
Name
CANON CITY PHYSIOTHERAPY INC
NPI
1154477065
Phone
(719) 269-1142
Address
903 MACON AVE
Authorized Official
MR. PAUL WAYNE PASCHALL OWNER P.T.
Enumeration Date
25 January 2007
Last Update Date
13 July 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience66
Completeness75
Years active:19State licenses:2Digital endpointsOther names

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Provider Addresses for CANON CITY PHYSIOTHERAPY INC

  • 903, Macon Avenue, Cañon City, Fremont County, Colorado, 81212, United States

    CANON CITY, CO 812123403

    Phone: (719) 269-1142

    Fax: (719) 269-1413

    Type: Mailing

  • 1107 MAIN ST

    CANON CITY, CO 812123413

    Phone: (719) 269-1142

    Fax: (719) 269-1413

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-09-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2026-05-31 (12 days ago).

Enrollment records

1

Earliest due date

2026-05-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040909000418OClinic/Group PracticeCO2026-05-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 81212)

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Reviews

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Frequently asked questions

What unique ID ties claims to CANON CITY PHYSIOTHERAPY INC?
NPI 1154477065 is assigned to CANON CITY PHYSIOTHERAPY INC under the national enumeration system.
Is CANON CITY PHYSIOTHERAPY INC active in the national directory?
CANON CITY PHYSIOTHERAPY INC's public NPI profile is in an active state.
Can you summarize CANON CITY PHYSIOTHERAPY INC's specialty in plain language?
Clinically, the directory lists CANON CITY PHYSIOTHERAPY INC with Physical Therapist. Clinical services aligned with this taxonomy classification.
What location metadata exists for CANON CITY PHYSIOTHERAPY INC?
The page summarizes Canon City, Colorado for CANON CITY PHYSIOTHERAPY INC; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Organization.

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