NPIMap

Organization Active NPI

Collinsville Physical Therapy & Wellness, LLC

  • Physical Therapist
  • Collinsville, IL
National Provider Identifier
1205033081
Registry record updated Nov 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
COLLINSVILLE PHYSICAL THERAPY & WELLNESS, LLC
Practice address
101 United Dr
Suite 100
Collinsville, IL 62234-7434
Phone
(618) 343-1122
Fax
(618) 343-1444
NPI assigned
Jun 27, 2007
Last updated
Nov 2, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2012

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

Authorized official

Name
Christopher J Albanese, PT
Title
Secretary
Phone
(845) 615-1585

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

101 United Dr
Suite 100
Collinsville, IL 62234-7434

Mailing address

PO Box 1007
Goshen, NY 10924-8007
Phone (845) 615-1585

National Provider Directory

National Provider Directory

Locations

101 United Dr
Ste 100
Collinsville, IL 62234
Phone (618) 343-1122

105 Lanter Ct
Collinsville, IL 62234
Phone (618) 343-1122

300 Edwardsville Rd
Ste 1
Troy, IL 62294
Phone (618) 667-3900

16 Maybrook Rd
Ste F
Campbell Hall, NY 10916

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351814400000",
    "number": "1205033081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1007",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109248007",
            "telephone_number": "845-615-1585",
            "fax_number": "845-615-1576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 UNITED DR",
            "address_2": "SUITE 100",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622347434",
            "telephone_number": "618-343-1122",
            "fax_number": "618-343-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLINSVILLE PHYSICAL THERAPY & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2012-11-02",
        "status": "A",
        "authorized_official_last_name": "ALBANESE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "845-615-1585",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collinsville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; 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.