Providence Physical Therapy Associates, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PROVIDENCE PHYSICAL THERAPY ASSOCIATES, INC.

Practice address

655 Broad St
Providence, RI 02907-1444

Phone

(401) 521-2214

Fax

(401) 861-4047

NPI assigned

May 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Walter Jude Scott, R.P.T., PH.D.

Title

President and Clinical Director

Phone

(401) 521-2214

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

Enrollment records 1

Practitioners 3

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

• Annmarie Duchesne

  • Physical Therapist
  • Pawtucket, RI
  • NPI 1861537896
  Medicare reassignment NPD
• Stephanie Hopkinson, PT

  • Physical Therapist
  • Providence, RI
  • NPI 1639299464
  Medicare reassignment NPD
• Sharyn Palumbo-Goldstein, RPT

  • Physical Therapist
  • Providence, RI
  • NPI 1881921526
  NPD (past)

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073726733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 BROAD ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029071444",
            "telephone_number": "401-521-2214",
            "fax_number": "401-861-4047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 BROAD ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029071444",
            "telephone_number": "401-521-2214",
            "fax_number": "401-861-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE PHYSICAL THERAPY ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "JUDE",
        "authorized_official_title_or_position": "PRESIDENT AND CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "401-521-2214",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "R.P.T., PH.D."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "RI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providence Metro Treatment Center
• Providence Nutrition, LLC
• Providence Orthodontics, LLC
• Providence Pediatrics
• Providence Perinatal Psychiatry
• Providence Prep Charter School
• Providence Preparatory Charter School
• Providence Psychology Services, LLC
• Providence Psychotherapy Clinic Inc
• Providence Refractive, L.L.C.

• Physical Therapy Clinic/Center in Providence, RI
• Providers in Providence, RI by specialty
• Physical Therapy Clinic/Center in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.