Active NPI
Lauren Stoddard, PTA
- Physical Therapy Assistant
- West Hartford, CT
National Provider Identifier
1134714967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 001802
- Practice address
- 29 Highland St
West Hartford, CT 06119-1398 - Phone
- (860) 236-5623
- NPI assigned
- Mar 3, 2021
- 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 Therapy Assistant | 225200000X | 001802 | CT | Primary |
Addresses
Primary practice location
29 Highland St
West Hartford, CT 06119-1398
Mailing address
46 Bellaire MNR
Cromwell, CT 06416-2105
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001802 | Other | CT | DPH |
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 |
|---|---|---|---|
| 001802 | CT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614729600000",
"number": "1134714967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46 BELLAIRE MNR",
"city": "CROMWELL",
"state": "CT",
"postal_code": "064162105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 HIGHLAND ST",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061191398",
"telephone_number": "860-236-5623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STODDARD",
"first_name": "LAUREN",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-03",
"last_updated": "2021-03-03",
"certification_date": "2021-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CT",
"license": "001802",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DPH",
"identifier": "001802",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.