Individual provider Active NPI

Vikram Sharad Shanbhag, MSPT

  • Physical Therapist
  • Naugatuck, CT
National Provider Identifier
1194910695
Registry record updated Sep 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501012956 Issued in MI
Practice address
151 Andrew Ave
Apt # 272
Naugatuck, CT 06770-4356
Phone
(203) 843-3550
NPI assigned
Sep 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2007

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 5501012956 MI Primary
Physical Therapist 225100000X 008046 CT
Physical Therapist 225100000X 05009140A IN
Physical Therapist 225100000X PT018527 PA

Addresses

Primary practice location

151 Andrew Ave
Apt # 272
Naugatuck, CT 06770-4356

Mailing address

151 Andrew Ave
Apt # 272
Naugatuck, CT 06770-4356
Phone (203) 843-3550

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

LicenseStateTypeSpecialty
05009140AINMDPhysical Therapist
5501012956MIMDPhysical Therapist
PT018527PAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1189209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189209600000",
    "number": "1194910695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 ANDREW AVE",
            "address_2": "APT # 272",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "067704356",
            "telephone_number": "203-843-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 ANDREW AVE",
            "address_2": "APT # 272",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "067704356",
            "telephone_number": "203-843-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANBHAG",
        "first_name": "VIKRAM",
        "middle_name": "SHARAD",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-08",
        "last_updated": "2007-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501012956",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "008046",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05009140A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT018527",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naugatuck, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.