Premier Physical Therapy of the Fingerlakes, PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

014144-1 Issued in NY

Legal business name

PREMIER PHYSICAL THERAPY OF THE FINGERLAKES, PLLC

Practice address

229 Parrish Street
Suite 220
Canandaigua, NY 14424

Phone

(585) 394-3920

Fax

(585) 394-3997

NPI assigned

Apr 6, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mitchell Robert Carlson, P.T.

Title

Owner

Phone

(585) 394-3920

Specialties & licenses 2

Addresses

Other identifiers 7

Locations

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276214400000",
    "number": "1255393930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 PARRISH STREET",
            "address_2": "SUITE 220",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "14424",
            "telephone_number": "585-394-3920",
            "fax_number": "585-394-3997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 PARRISH STREET",
            "address_2": "SUITE 220",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "14424",
            "telephone_number": "585-394-3920",
            "fax_number": "585-394-3997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PHYSICAL THERAPY OF THE FINGERLAKES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2010-06-11",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-394-3920",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "014144-1",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS BC BS",
            "identifier": "020114144",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02632479",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS BLUE CHOICE",
            "identifier": "0185042370",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DC4683",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "601318000",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7735556",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "145851FT",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mindy Porteus, LPN
• Beth Ann Potter, R.N.F.A.
• Jill K Potts, M.D.
• Andrew Powers, M.D.
• Charles Robert Pratt, DDS
• Jenna Prewasnicak
• Priestman Chiropractic PC
• Michael B Priestman, DC
• Princeton Consulting and Therapy, LLC
• Samantha Pritty

• Physical Therapy Clinic/Center in Canandaigua, NY
• Providers in Canandaigua, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2010; 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.