Orthopedic & Sports Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

012257-1 Issued in NY

Legal business name

ORTHOPEDIC & SPORTS PHYSICAL THERAPY, LLC

Practice address

5586 Legionnaire Dr
Suite 6
Cicero, NY 13039-3504

Phone

(315) 698-9353

Fax

(315) 698-4463

NPI assigned

Dec 26, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Cole David Taylor, P.T.NPI 1457391054

Title

P.T.Owner

Phone

(315) 698-9353

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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.

• Cole David Taylor, PHYSICAL THERAPIST

  • Legal Medicine
  • Cicero, NY
  • NPI 1457391054
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327449600000",
    "number": "1073678447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5586 LEGIONNAIRE DR",
            "address_2": "SUITE 6",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "130393504",
            "telephone_number": "315-698-9353",
            "fax_number": "315-698-4463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5586 LEGIONNAIRE DR",
            "address_2": "SUITE 6",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "130393504",
            "telephone_number": "315-698-9353",
            "fax_number": "315-698-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC & SPORTS PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2012-01-25",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "COLE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "P.T.OWNER",
        "authorized_official_telephone_number": "315-698-9353",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "012257-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Molly Paciorek, LMHC
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• Laura R Panzarella, PT
• Nicole Parrish, RPH

• Physical Therapist in Cicero, NY
• Providers in Cicero, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; 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.