Active NPI
Melissa J Williams, MSPT
- Physical Therapist
- Rome, NY
National Provider Identifier
1104837715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0275031
- Practice address
- 221 S James St
Bouton Physical Therapy
Rome, NY 13440 - Phone
- (315) 337-1436
- Fax
- (315) 337-1437
- NPI assigned
- Aug 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 0275031 | NY | Primary |
Addresses
Primary practice location
221 S James St
Bouton Physical Therapy
Rome, NY 13440
Mailing address
221 S James St
Bouton Physical Therapy
Rome, NY 13440
Phone (315) 337-1436
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10101063 | Other | CDPHP | |
| PO10027503 | Other | EXCELLUS | |
| 02692693 | Medicaid | NY | |
| 051213000065 | Other | FIDELIS | |
| 385413 | Other | MVP | |
| 6696836 | Other | GHI | |
| 7343747 | Other | AETNA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0275031 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216080000000",
"number": "1104837715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "221 S JAMES ST",
"address_2": "BOUTON PHYSICAL THERAPY",
"city": "ROME",
"state": "NY",
"postal_code": "13440",
"telephone_number": "315-337-1436",
"fax_number": "315-337-1437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 S JAMES ST",
"address_2": "BOUTON PHYSICAL THERAPY",
"city": "ROME",
"state": "NY",
"postal_code": "13440",
"telephone_number": "315-337-1436",
"fax_number": "315-337-1437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "MELISSA",
"middle_name": "J",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-10",
"last_updated": "2008-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "0275031",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPHP",
"identifier": "10101063",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EXCELLUS",
"identifier": "PO10027503",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02692693",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIDELIS",
"identifier": "051213000065",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "385413",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "6696836",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7343747",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Rome, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.