Active NPI
Craig R Denegar, PT
- Physical Therapist
- Storrs Mansfield, CT
National Provider Identifier
1023072345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT007701L
- Practice address
- Physical Therapy
358 Mansfield Road, Unit 2101
Storrs Mansfield, CT 06269-2101 - Phone
- (860) 486-0052
- Fax
- (860) 486-1158
- NPI assigned
- Apr 13, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT007701L | PA | Primary |
Addresses
Primary practice location
Physical Therapy
358 Mansfield Road, Unit 2101
Storrs Mansfield, CT 06269-2101
Mailing address
Physical Therapy
358 Mansfield Road, Unit 2101
Storrs, CT 06269-2101
Phone (860) 486-0052
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 |
|---|---|---|---|
| PT007701L | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023072345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PHYSICAL THERAPY",
"address_2": "358 MANSFIELD ROAD, UNIT 2101",
"city": "STORRS",
"state": "CT",
"postal_code": "062692101",
"telephone_number": "860-486-0052",
"fax_number": "860-486-1158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PHYSICAL THERAPY",
"address_2": "358 MANSFIELD ROAD, UNIT 2101",
"city": "STORRS MANSFIELD",
"state": "CT",
"postal_code": "062692101",
"telephone_number": "860-486-0052",
"fax_number": "860-486-1158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENEGAR",
"first_name": "CRAIG",
"middle_name": "R",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT007701L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Storrs Mansfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.