Eric Tharaldson Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ERIC THARALDSON PHYSICAL THERAPY LLC

Doing business as

PT at Home

Practice address

3 Roberts St
Windsor Locks, CT 06096-2113

Phone

(860) 712-4876

NPI assigned

Mar 2, 2022

Last updated

Mar 2, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eric TharaldsonNPI 1386858553

Title

Owner

Phone

(860) 712-4876

Specialties & licenses 1

Addresses

Other names 1

• PT AT HOME Doing business as

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 2

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.

• Eric Tharaldson, PT

  • Physical Therapist
  • Simsbury, CT
  • NPI 1386858553
  Medicare reassignment NPD Authorized official
• Rebecca Jean Tharaldson, PTA

  • Physical Therapy Assistant
  • Windsor, CT
  • NPI 1871749697
  NPD

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1336895143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 ROBERTS ST",
            "city": "WINDSOR LOCKS",
            "state": "CT",
            "postal_code": "060962113",
            "telephone_number": "860-712-4876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ROBERTS ST",
            "city": "WINDSOR LOCKS",
            "state": "CT",
            "postal_code": "060962113",
            "telephone_number": "860-712-4876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC THARALDSON PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "THARALDSON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-712-4876"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PT AT HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amber Curran
• Marc Samuel Cutler, PHD
• Eastern Services & Camp Simon LLC
• Ayesha Ejaz, DMD
• Elegant, LLC.
• Essential Services, LLC
• Ezee Transort LLC
• Lorri F Fitzsimmons, LCSW
• David Gallagher, LCSW
• Lisa Jean Geckler

• Physical Therapy Clinic/Center in Windsor Locks, CT
• Providers in Windsor Locks, CT by specialty
• Physical Therapy Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.