NPIMap

Organization Active NPI

Danbury Physical Medicine and Rehabilitation PC

  • Physical Medicine & Rehabilitation Physician
  • Danbury, CT
National Provider Identifier
1306087838
Registry record updated Dec 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
043130 Issued in CT
Legal business name
DANBURY PHYSICAL MEDICINE AND REHABILITATION PC
Practice address
109 Newton Rd
Suite 1
Danbury, CT 06810-4120
Phone
(203) 207-9840
Fax
(203) 207-9849
NPI assigned
Mar 12, 2009
Last updated
Dec 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Nikki C Blayzor
Title
Manager
Phone
(203) 207-9840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 043130 CT Primary

Addresses

Primary practice location

109 Newton Rd
Suite 1
Danbury, CT 06810-4120

Mailing address

109 Newton Rd
Suite 1
Danbury, CT 06810-4120
Phone (203) 207-9840

Other identifiers 1

IdentifierTypeStateIssuer
D100007621OtherCTMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

109 Newtown Rd
#1
Danbury, CT 06810
Phone (203) 207-9840

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259712000000",
    "number": "1306087838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 NEWTON RD",
            "address_2": "SUITE 1",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068104120",
            "telephone_number": "203-207-9840",
            "fax_number": "203-207-9849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 NEWTON RD",
            "address_2": "SUITE 1",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068104120",
            "telephone_number": "203-207-9840",
            "fax_number": "203-207-9849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANBURY PHYSICAL MEDICINE AND REHABILITATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-12",
        "last_updated": "2009-12-02",
        "status": "A",
        "authorized_official_last_name": "BLAYZOR",
        "authorized_official_first_name": "NIKKI",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "203-207-9840",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CT",
            "license": "043130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "D100007621",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.