Edith E Decraene, PT
Physical Therapist in Evergreen, CO. Individual provider (NPI-1).
NPI number1902991920
StatusActive
Last updated in NPPESOct 23, 2007
Details
- NPI
- 1902991920
- Entity type
- Individual (NPI-1)
- Name
- Edith E Decraene
- Credential
- PT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 4, 2006
- Last updated
- Oct 23, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 3525 | CO | Yes |
Practice location
2942 Evergreen PkwySte 100
Evergreen, CO 80439-7909
Phone 303-670-4802
Mailing address
2942 Evergreen Pkwy Ste 100Evergreen, CO 80439-7909
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 63 Physical Therapist providers in Evergreen · All 664 providers in Evergreen
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