Orthopedic & Spine Physical Therapy of L/a Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT2321 Issued in ME

Legal business name

ORTHOPEDIC & SPINE PHYSICAL THERAPY OF L/A INC.

Practice address

581 Main St
Suite 1
Lewiston, ME 04240-5945

Phone

(207) 777-3002

Fax

(207) 777-3004

NPI assigned

May 25, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Shan Martin Teixeira, PT, MOMT,OCSNPI 1568431401

Title

Physical Therapist/ Owner

Phone

(207) 777-3002

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shan Martin Teixeira, PT, MOMT, OCS

  • Orthopedic Physical Therapist
  • Lewiston, ME
  • NPI 1568431401
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291852800000",
    "number": "1043266646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "581 MAIN ST",
            "address_2": "SUITE 1",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405945",
            "telephone_number": "207-777-3002",
            "fax_number": "207-777-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "581 MAIN ST",
            "address_2": "SUITE 1",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405945",
            "telephone_number": "207-777-3002",
            "fax_number": "207-777-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC & SPINE PHYSICAL THERAPY OF L/A INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2010-12-09",
        "status": "A",
        "authorized_official_last_name": "TEIXEIRA",
        "authorized_official_first_name": "SHAN",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/ OWNER",
        "authorized_official_telephone_number": "207-777-3002",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT, MOMT,OCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT2321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.