NPIMap

Organization Active NPI

Orthopaedic Physical Therapy Associates

  • Orthopedic Physical Therapist
  • Scarborough, ME
National Provider Identifier
1063622702
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT966 Issued in ME
Legal business name
ORTHOPAEDIC PHYSICAL THERAPY ASSOCIATES
Practice address
360 US Route 1
Scarborough, ME 04074-9772
Phone
(207) 883-6789
Fax
(207) 885-9394
NPI assigned
May 23, 2007
Organization subpart
Yes
Parent organization
OTHOPAEDIC PHYSICAL THERAPY ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

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

Authorized official

Name
Mr. Kenneth N Simons, PT,DPT,MS,OCSNPI 1760429096
Title
President
Phone
(207) 883-6789

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X PT966 ME Primary

Addresses

Primary practice location

360 US Route 1
Scarborough, ME 04074-9772

Mailing address

360 US Route 1
Scarborough, ME 04074-9772
Phone (207) 883-6789

Other identifiers 2

IdentifierTypeStateIssuer
048994OtherMEANTHEM
MN2093OtherMEHARVARD PILGRIM

National Provider Directory

National Provider Directory
Tax ID family
Orthopaedic Physical Therapy Associates2 organizations share this tax ID, including this one
Part of
Orthopaedic Physical Therapy Associates

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

360 US Route 1
Scarborough, ME 04074
Phone (207) 883-6789

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196899200000",
    "number": "1063622702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749772",
            "telephone_number": "207-883-6789",
            "fax_number": "207-885-9394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749772",
            "telephone_number": "207-883-6789",
            "fax_number": "207-885-9394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC PHYSICAL THERAPY ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OTHOPAEDIC PHYSICAL THERAPY ASSOCIATES",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-12-06",
        "status": "A",
        "authorized_official_last_name": "SIMONS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-883-6789",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT,DPT,MS,OCS"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "ME",
            "license": "PT966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "048994",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "MN2093",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.

Verify at the official NPI Registry.