Active NPI
Shea Frady
- Orthopedic Physical Therapist
- Storrs, CT
National Provider Identifier
1003646084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 14533
- Practice address
- 9 Dog LN Ste 108
Storrs, CT 06268-2239 - Phone
- (860) 429-0899
- NPI assigned
- Aug 5, 2024
- Last updated
- Aug 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 14533 | CT | Primary |
Addresses
Primary practice location
9 Dog LN Ste 108
Storrs, CT 06268-2239
Mailing address
305 Storrs Rd
Mansfield Center, CT 06250-1216
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14533 | CT | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722816000000",
"number": "1003646084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 STORRS RD",
"city": "MANSFIELD CENTER",
"state": "CT",
"postal_code": "062501216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 DOG LN STE 108",
"city": "STORRS",
"state": "CT",
"postal_code": "062682239",
"telephone_number": "860-429-0899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRADY",
"first_name": "SHEA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-05",
"last_updated": "2024-08-05",
"certification_date": "2024-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CT",
"license": "14533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Storrs, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.