Individual provider Active NPI

Brian Roberts

  • Physical Therapist
  • Greenwich, CT
National Provider Identifier
1073251971
Registry record updated May 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
75 Holly Hill LN
Greenwich, CT 06830-6098
Phone
(203) 276-8526
NPI assigned
May 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

75 Holly Hill LN
Greenwich, CT 06830-6098

Mailing address

8 Candlewood Knolls Rd
New Fairfield, CT 06812-4244
Phone (201) 919-8949

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://mycw46.eclinicalweb.com/portal5317/jsp/100mp/login_otp.jsp

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

NPI Registry JSON

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

{
    "created_epoch": "1653177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653177600000",
    "number": "1073251971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CANDLEWOOD KNOLLS RD",
            "city": "NEW FAIRFIELD",
            "state": "CT",
            "postal_code": "068124244",
            "telephone_number": "201-919-8949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 HOLLY HILL LN",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068306098",
            "telephone_number": "203-276-8526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-22",
        "last_updated": "2022-05-22",
        "certification_date": "2022-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://mycw46.eclinicalweb.com/portal5317/jsp/100mp/login_otp.jsp",
            "affiliation": "N",
            "address_1": "1 Hospital Plz",
            "city": "Stamford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "069023602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2022; 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.