NPIMap

Individual provider Active NPI

Bryan M Mehigen, DPT

  • Physical Therapist
  • Rocky Hill, CT
National Provider Identifier
1053661785
Registry record updated Sep 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9536 Issued in CT
Practice address
506 Cromwell Ave Ste 103
Rocky Hill, CT 06067-1851
Phone
(860) 721-9801
Fax
(860) 721-8475
NPI assigned
Sep 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2012

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9536 CT Primary
Geriatric Physical Therapist 2251G0304X 9536 CT
Neurology Physical Therapist 2251N0400X 9536 CT
Sports Physical Therapist 2251S0007X 9536 CT
Orthopedic Physical Therapist 2251X0800X 9536 CT

Addresses

Primary practice location

506 Cromwell Ave Ste 103
Rocky Hill, CT 06067-1851

Mailing address

506 Cromwell Ave Ste 103
Rocky Hill, CT 06067-1851
Phone (860) 721-9801

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
9536CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Physical Therapy & Sports Medicine Center, LLC Physical Therapist PastSince Nov 1, 2012 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1053661785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 CROMWELL AVE STE 103",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060671851",
            "telephone_number": "860-721-9801",
            "fax_number": "860-721-8475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 CROMWELL AVE STE 103",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060671851",
            "telephone_number": "860-721-9801",
            "fax_number": "860-721-8475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHIGEN",
        "first_name": "BRYAN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-10",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "9536",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "CT",
            "license": "9536",
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "CT",
            "license": "9536",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "CT",
            "license": "9536",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CT",
            "license": "9536",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Hill, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.