Active NPI
Carol Kelleher, PT
- Orthopedic Physical Therapist
- Windsor, CT
National Provider Identifier
1295801801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 002794
- Practice address
- 6 Poquonock Ave
Windsor, CT 06095-2507 - Phone
- (860) 683-0080
- Fax
- (860) 683-2614
- NPI assigned
- Nov 27, 2006
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 002794 | CT | Primary |
Addresses
Primary practice location
6 Poquonock Ave
Windsor, CT 06095-2507
Mailing address
7 Spring Meadow Dr
Granby, CT 06035-1328
Phone (860) 653-8090
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 |
|---|---|---|---|
| 002794 | CT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295801801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 SPRING MEADOW DR",
"city": "GRANBY",
"state": "CT",
"postal_code": "060351328",
"telephone_number": "860-653-8090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 POQUONOCK AVE",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060952507",
"telephone_number": "860-683-0080",
"fax_number": "860-683-2614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEHER",
"first_name": "CAROL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CT",
"license": "002794",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Windsor, 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.