Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mackenzie Sue Rae Whiteside

Individual provider Physical Therapist · NPI 1831055219

Mackenzie Sue Rae Whiteside is a Physical Therapist in Private Practice in Boulder, Colorado. Qualified in 2025, 1 year ago. Practices with Boulder Community Health, a 253-clinician group and accepts Medicare assignment. Licensed in Colorado.

Years since qualifying
1
Licensed in
CO
In the registry since
2025
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Practice location Address checks out

2150 Stadium Drive 2nd Fl
Boulder, CO 80309-0001
Phone: (303) 315-9900
Fax: (303) 315-9902
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PTL.0021024 (CO)

Record details

NPI number1831055219
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 30, 2025
Last updated in NPPESDecember 30, 2025
Certification dateDecember 30, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Boulder Community Health — 253 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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