Individual provider Active NPI

Rebecca M Underwood, P.T.

  • Physical Therapist
  • Colebrook, NH
National Provider Identifier
1134178775
Registry record updated May 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
118 Main St Ste 6
Colebrook, NH 03576
Phone
(603) 237-9300
Fax
(603) 237-9320
NPI assigned
May 10, 2006
Last updated
May 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0991 NH
Physical Therapist 225100000X 6587 MA
Physical Therapist 225100000X Primary

Addresses

Primary practice location

118 Main St Ste 6
Colebrook, NH 03576

Mailing address

118 Main St Ste 6
Colebrook, NH 03576-2000
Phone (603) 237-9300

Other identifiers 1

IdentifierTypeStateIssuer
3100959MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150428000271 NH Practitioner - Physical Therapist in Private Practice 5890603427 Reassigns benefits to 1 organization
Practice locations: Colebrook, NH

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6587MAMDDental Hygienist
0991NHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Derry Sports & Rehab LLC Physical Therapist CurrentSince May 11, 2020 Accepting new patients
Derry Sports & Rehab, LLC Physical Therapist CurrentSince May 11, 2020 Accepting new patients

Locations

45 Danville Rd
East Hampstead, NH 03826
Phone (603) 382-0019

55 Bridge St
Manchester, NH 03101

159 N Broadway
Ste 2A
Salem, NH 03079
Phone (603) 644-5900

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527465600000",
    "number": "1134178775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 MAIN ST STE 6",
            "city": "COLEBROOK",
            "state": "NH",
            "postal_code": "035762000",
            "telephone_number": "603-237-9300",
            "fax_number": "603-237-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 MAIN ST STE 6",
            "city": "COLEBROOK",
            "state": "NH",
            "postal_code": "03576",
            "telephone_number": "603-237-9300",
            "fax_number": "603-237-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "REBECCA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2018-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "0991",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "6587",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3100959",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colebrook, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2018; 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.