MUSTARD SEED WELLNESS, PC (NPI# 1053577759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053577759 |
| Entity Type | Organization |
| Organization Name | MUSTARD SEED WELLNESS, PC |
| Other Organization Name | IMPACT SPORTS MEDICINE |
| Practice Address |
11025 Dover St Suite 400 Westminster CO 80021-5570 |
| Mailing Address |
Po Box 270217 Louisville CO 80027-5003 |
| Practice Telephone | 3039025456 |
| Mailing Telephone | 3039025456 |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2008-09-30 |
| Authorized Official Name | KEITH E CHRISTIANSSEN (CEO) |
| Authorized Official Telephone | 3039025456 |
| Authorized Official Credential | PT, ATC, MTC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| IMPACT SPORTS MEDICINE | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | MUSTARD SEED WELLNESS, PC | 3303 West 144th Ave, Suite 105, Broomfield, CO 80023 |
| Street Address |
11025 DOVER ST SUITE 400 |
| City | WESTMINSTER |
| State | CO |
| Zip Code | 80021-5570 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639467863 | Rachel M Kroncke | Physical Therapist | 11025 Dover St, Suite 400, Westminster, CO 80021-5570 | 2011-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851941934 | Denver Restorative Dentistry Pllc | Dentist | 8181 Arista Place, Suite 140, Broomfield, CO 80021 | 2019-09-19 |
| 1205490398 | Amber Kay Kisser | Occupational Therapist | 7770 W 101st Ave, Westminster, CO 80021 | 2019-04-24 |
| 1871093138 | Samantha Ewing | Audiologist | 403 Summit Blvd., # 204, Broomfield, CO 80021 | 2018-02-13 |
| 1568978914 | Denver Recovery Center, LLC | Clinic/Center | 295 Interlocken Blvd Ste 400, Broomfield, CO 80021 | 2017-12-21 |
| 1730601477 | Elaine H Kim | Audiologist | 120 Edgeview Dr., Unit 6220, Broomfield, CO 80021 | 2017-07-14 |
| 1245605575 | Profound Fitness, LLC | Day Training, Developmentally Disabled Services | 7721 W 92nd Ave, Westminster, CO 80021 | 2015-12-11 |
| 1558785634 | Nichelle Francavilla Gurule | Chiropractor | 11336 W 104th Ave, Westminster, CO 80021 | 2014-02-10 |
| 1255770244 | Martha Ha | Dentist | 645 Flatiron Marketplace Dr Unit A, Broomfield, CO 80021 | 2013-06-23 |
| 1467737841 | Nathaniel Weidner | Pharmacist | 10350 Dover St. D28, Westminster, CO 80021 | 2011-10-17 |
| 1346475209 | Christine Marie Maren | Family Medicine | 8181 Arista Pl Unit 100, Broomfield, CO 80021 | 2009-05-21 |
| Find all providers in zip 80021 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629686894 | Panorama Orthopedics & Spine Center, PC | Clinic/Center | 5540 Main Street, Suite #200, Westminster, CO 80031 | 2020-07-14 |
| 1053873596 | T-0 Sports Performance LLC | Clinic/Center | 12005 Pecos St, Westminster, CO 80234-2073 | 2019-04-03 |
| 1538450150 | Core Health, LLC | Clinic/Center | 5165 W 72nd Ave Ste B, Westminster, CO 80030-5137 | 2011-04-29 |
| 1750600391 | Comprehensive Care Physical Therapy Services, Inc. | Clinic/Center | 15436 Brookhurst St, Westminster, CA 92683-7057 | 2010-05-21 |
| 1134325590 | Anitha N Rangarajan | Clinic/Center | 686 Poole Road, Suite C, Westminster, MD 21157 | 2007-06-22 |
| 1427671536 | Unite.rehab.perform LLC | Clinic/Center | 1401 W 122nd Ave Ste 110, Westminster, CO 80234-4900 | 2020-05-22 |
| 1699397794 | Panorama Orthopedics & Spine Center, PC | Clinic/Center | 8510 Bryant St Ste 130, Westminster, CO 80031-3845 | 2020-05-12 |
| 1710519848 | Centura Ventures, LLC | Clinic/Center | 7233 Church Ranch Blvd, Westminster, CO 80021-4094 | 2020-02-06 |
| 1306481585 | Rebound Physical Therapy Group, LLC | Clinic/Center | 19 Liberty St Ste 1, Westminster, MD 21157-4914 | 2019-11-12 |
| 1922642859 | Reform Health & Rehab, LLC | Clinic/Center | 2861 W 120th Ave Ste 120, Westminster, CO 80234-2985 | 2019-11-04 |
| Find all providers in WESTMINSTER | ||||
| City | WESTMINSTER |
| Zip Code | 80021 |
Please comment or provide details below to improve the information on MUSTARD SEED WELLNESS, PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.