Individual provider Active NPI

Lauren Colley, PTA

  • Physical Therapy Assistant
  • Dover Foxcroft, ME
National Provider Identifier
1114377892
Registry record updated Feb 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PA4676 Issued in ME
Practice address
69 Pleasant St
Dover Foxcroft, ME 04426-1239
Phone
(207) 745-7742
NPI assigned
Jun 14, 2016
Last updated
Feb 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PA4676 ME Primary

Addresses

Primary practice location

69 Pleasant St
Dover Foxcroft, ME 04426-1239

Mailing address

262 Main St Apt B
Bradley, ME 04411-5112

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

State licenses

LicenseStateTypeSpecialty
PA4676MEMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1114377892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 MAIN ST APT B",
            "city": "BRADLEY",
            "state": "ME",
            "postal_code": "044115112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 PLEASANT ST",
            "city": "DOVER FOXCROFT",
            "state": "ME",
            "postal_code": "044261239",
            "telephone_number": "207-745-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLEY",
        "first_name": "LAUREN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-14",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ME",
            "license": "PA4676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover Foxcroft, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2019; 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.