NPIMap

Organization Active NPI

Sport & Spine Physical Therapy Inc

  • Physical Therapist
  • West Warwick, RI
National Provider Identifier
1164595609
Registry record updated Oct 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SPORT & SPINE PHYSICAL THERAPY INC
Practice address
328 Cowesett Ave
Suite 6
West Warwick, RI 02893-2248
Phone
(401) 823-8856
Fax
(401) 826-8234
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2011

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

Authorized official

Name
Mrs. Colleen S McGloinNPI 1134292535
Title
President
Phone
(401) 823-8856

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

328 Cowesett Ave
Suite 6
West Warwick, RI 02893-2248

Mailing address

328 Cowesett Ave
Suite 6
West Warwick, RI 02893-2248
Phone (401) 823-8856

Other names 1

  • S Corp Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040714000030 RI Part B Supplier - Clinic/Group Practice 5890689541 Receives reassigned benefits from 5 practitioners
Practice locations: Coventry, RI; West Warwick, RI

National Provider Directory

National Provider Directory

Locations

45 Sandy Bottom Rd
Coventry, RI 02816
Phone (401) 381-0515

328 Cowesett Ave
Ste 6
West Warwick, RI 02893
Phone (401) 821-6091

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319414400000",
    "number": "1164595609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 COWESETT AVE",
            "address_2": "SUITE 6",
            "city": "WEST WARWICK",
            "state": "RI",
            "postal_code": "028932248",
            "telephone_number": "401-823-8856",
            "fax_number": "401-826-8234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 COWESETT AVE",
            "address_2": "SUITE 6",
            "city": "WEST WARWICK",
            "state": "RI",
            "postal_code": "028932248",
            "telephone_number": "401-823-8856",
            "fax_number": "401-826-8234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORT & SPINE PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2011-10-24",
        "status": "A",
        "authorized_official_last_name": "MCGLOIN",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-823-8856",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "S Corp",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; 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.