Active NPI
Carole L. Moore, PT
- Physical Therapist
- New London, CT
National Provider Identifier
1275669095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 003896
- Practice address
- 6 Shaws CV
Ste 101
New London, CT 06320-4969 - Phone
- (860) 447-3009
- Fax
- (860) 447-1320
- NPI assigned
- Feb 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 003896 | CT | Primary |
Addresses
Primary practice location
6 Shaws CV
Ste 101
New London, CT 06320-4969
Mailing address
31 Old Route 7
Brookfield, CT 06804-1714
Phone (203) 740-0020
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003896 | CT | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275669095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 OLD ROUTE 7",
"city": "BROOKFIELD",
"state": "CT",
"postal_code": "068041714",
"telephone_number": "203-740-0020",
"fax_number": "203-775-0238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 SHAWS CV",
"address_2": "STE 101",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063204969",
"telephone_number": "860-447-3009",
"fax_number": "860-447-1320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "CAROLE",
"middle_name": "L.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "003896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New London, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.