Provider Demographics
NPI:1902422157
Name:MILESTONE PEDIATRIC THERAPY SERVICES
Entity Type:Organization
Organization Name:MILESTONE PEDIATRIC THERAPY SERVICES
Other - Org Name:HEALTHPRO PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERRA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:303-437-4364
Mailing Address - Street 1:7720 E BELLEVIEW AVE STE B106
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2612
Mailing Address - Country:US
Mailing Address - Phone:303-437-4364
Mailing Address - Fax:303-223-3462
Practice Address - Street 1:695 S COLORADO BLVD STE 20
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-8010
Practice Address - Country:US
Practice Address - Phone:303-360-0727
Practice Address - Fax:303-360-0758
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MILESTONE PEDIATRIC THERAPY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-23
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO50370570Medicaid