Active NPI
Christine M Malcom, P.T.
- Physical Therapist
- Groton, CT
National Provider Identifier
1124300363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 006281
- Practice address
- 425 Drozdyk Dr
Groton, CT 06340-4248 - Phone
- (860) 333-1959
- Fax
- (860) 333-1960
- NPI assigned
- Sep 14, 2011
- 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 | 006281 | CT | Primary |
Addresses
Primary practice location
425 Drozdyk Dr
Groton, CT 06340-4248
Mailing address
425 Drozdyk Drive
Groton, CT 06340
Phone (860) 333-1959
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
| License | State | Type | Specialty |
|---|---|---|---|
| 006281 | CT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315958400000",
"number": "1124300363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 DROZDYK DRIVE",
"city": "GROTON",
"state": "CT",
"postal_code": "06340",
"telephone_number": "860-333-1959",
"fax_number": "860-333-1960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 DROZDYK DR",
"city": "GROTON",
"state": "CT",
"postal_code": "063404248",
"telephone_number": "860-333-1959",
"fax_number": "860-333-1960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALCOM",
"first_name": "CHRISTINE",
"middle_name": "M",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-14",
"last_updated": "2011-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "006281",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Groton, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.