Active NPI
Lynette Roy, PTA
- Physical Therapy Assistant
- Avon, CT
National Provider Identifier
1306005384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 000855
- Practice address
- 100 Simsbury Road
Avon, CT 06001 - Phone
- (860) 674-0255
- Fax
- (860) 674-3727
- NPI assigned
- Jun 5, 2008
- 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 Therapy Assistant | 225200000X | 000855 | CT | Primary |
Addresses
Primary practice location
100 Simsbury Road
Avon, CT 06001
Mailing address
181 Patricia M Genova Drive
Eastern Rehabilitation Network
Newington, CT 06111
Phone (860) 667-5480
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000855 | CT | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212624000000",
"number": "1306005384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "181 PATRICIA M GENOVA DRIVE",
"address_2": "EASTERN REHABILITATION NETWORK",
"city": "NEWINGTON",
"state": "CT",
"postal_code": "06111",
"telephone_number": "860-667-5480",
"fax_number": "860-667-8416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 SIMSBURY ROAD",
"city": "AVON",
"state": "CT",
"postal_code": "06001",
"telephone_number": "860-674-0255",
"fax_number": "860-674-3727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROY",
"first_name": "LYNETTE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-05",
"last_updated": "2008-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CT",
"license": "000855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avon, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.