Active NPI
Melissa S. Booth, P.T.
- Physical Therapist
- Branford, CT
National Provider Identifier
1285875567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7549
- Practice address
- 1224 Main St
Branford, CT 06405-3778 - Phone
- (203) 483-3825
- NPI assigned
- Mar 16, 2009
- Last updated
- Jul 15, 2016
- 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 | 7549 | CT | Primary |
Addresses
Primary practice location
1224 Main St
Branford, CT 06405-3778
Mailing address
2408 Whitney Ave
Hamden, CT 06518-3209
Phone (203) 483-3825
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285875567 | Medicaid | CT |
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 |
|---|---|---|---|
| 7549 | CT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468540800000",
"number": "1285875567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2408 WHITNEY AVE",
"city": "HAMDEN",
"state": "CT",
"postal_code": "065183209",
"telephone_number": "203-483-3825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1224 MAIN ST",
"city": "BRANFORD",
"state": "CT",
"postal_code": "064053778",
"telephone_number": "203-483-3825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOOTH",
"first_name": "MELISSA",
"middle_name": "S.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-16",
"last_updated": "2016-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "7549",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1285875567",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Branford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.