Individual provider Active NPI

Lori Rothrock, PT, MPT

  • Physical Therapist
  • Groton, CT
National Provider Identifier
1184046625
Registry record updated Mar 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
011340 Issued in CT
Practice address
1 Wahoo Drive
Groton, CT 06349-3809
Phone
(860) 694-4974
NPI assigned
Jan 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 60311223 WA
Physical Therapist 225100000X 15705 MA
Physical Therapist 225100000X 21817 MD
Physical Therapist 225100000X 011340 CT Primary

Addresses

Primary practice location

1 Wahoo Drive
Groton, CT 06349-3809

Mailing address

33 Elm St
Deep River, CT 06417-1740
Phone (410) 980-7200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180912000798 CT Practitioner - Physical Therapist in Private Practice 2264736941 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011340CTMDDentist
21817MDMDPharmacist
15705MAMDPhysical Therapist
60311223WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ptsma Inc CurrentSince Oct 1, 2022 Accepting new patients
Patterson Physical Therapy Inc Physical Therapist CurrentSince Jan 1, 2024 Accepting new patients
Ptsma, Inc. CurrentSince Oct 1, 2022 Accepting new patients
Fox Rehab PT CT, LLC Physical Therapist CurrentSince Sep 20, 2018 Accepting new patients
Ptsma, Inc. Physical Therapist Current Accepting new patients

Locations

215 E Main St
Clinton, CT 06413
Phone (860) 669-6636

668 Bank St
New London, CT 06320
Phone (860) 442-4600

37 S Broad St
Ste 12
Pawcatuck, CT 06379
Phone (860) 495-1919

650 Ritchie Hwy
Ste 103
Severna Park, MD 21146
Phone (410) 647-1961

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1389916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583625600000",
    "number": "1184046625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 ELM ST",
            "city": "DEEP RIVER",
            "state": "CT",
            "postal_code": "064171740",
            "telephone_number": "410-980-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WAHOO DRIVE",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063493809",
            "telephone_number": "860-694-4974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHROCK",
        "first_name": "LORI",
        "name_prefix": "Mrs.",
        "credential": "PT, MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-17",
        "last_updated": "2020-03-08",
        "certification_date": "2020-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "60311223",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "15705",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "21817",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "011340",
            "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 Mar 8, 2020; 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.