Beth Ann Flannery Spillane, PT
Individual provider Active NPI Physical Therapist · North Grosvenordale, CT
NPI 1285618488 · NPPES record last updated Mar 9, 2023
Key facts
- NPI
- 1285618488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 10235 (MA)
- Practice address
- 113 Labby Rd
North Grosvenordale, CT 06255-1247 - Phone
- (860) 497-0239
- Fax
- (860) 497-0047
- NPI assigned
- Dec 1, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040607001210 | MA | Practitioner - Physical Therapist in Private Practice | 0648252106 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Outpatient Mobile | Physical Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10235 | MA | Yes |
Addresses
Primary practice location
113 Labby Rd
North Grosvenordale, CT 06255-1247
Mailing address
113 Labby Rd
North Grosvenordale, CT 06255-1247
Phone (860) 497-0239
Other practice location 1
365 Main St Ste 101
Worcester, MA 01608-1710
Phone (860) 497-0239
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0325660 | Medicaid | MA |
Other names
- Beth Flannery
Other providers in North Grosvenordale, CT
- Nita Chatterjee
- Natalee Giselle Cifuentes
- Tanya Lee Clark
- Lisa Kim Diamond
- Kristine Marie Dipasquale
- Melissa Ann Gobin-Borski
- Christina M Labby
- Jennifer Ann Martell
- Alyssa J Mawson
- Melissa Gobin, Licsw, LCSW LLC
All providers in North Grosvenordale, CT · Physical Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.