Individual provider Active NPI

Chelsea Michelle Goldthwait, P.T.A.

  • Physical Therapy Assistant
  • Oswego, NY
National Provider Identifier
1053688523
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
66007735 Issued in NY
Practice address
159 W 1St St
Oswego, NY 13126-2045
Phone
(315) 342-9575
Fax
(315) 342-7664
NPI assigned
Nov 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 66007735 NY Primary

Addresses

Primary practice location

159 W 1St St
Oswego, NY 13126-2045

Mailing address

7407 Ventura Cir
Liverpool, NY 13088-4731
Phone (315) 451-0760

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

LicenseStateTypeSpecialty
66007735NYMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322438400000",
    "number": "1053688523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7407 VENTURA CIR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130884731",
            "telephone_number": "315-451-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 W 1ST ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262045",
            "telephone_number": "315-342-9575",
            "fax_number": "315-342-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDTHWAIT",
        "first_name": "CHELSEA",
        "middle_name": "MICHELLE",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-28",
        "last_updated": "2011-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "66007735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; 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.