Individual provider Active NPI

Cecilia J. Shane, PT

  • Physical Therapist
  • New Milford, CT
National Provider Identifier
1346679271
Registry record updated Nov 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
009807 Issued in CT
Practice address
130B Grove St
New Milford, CT 06776-3668
Phone
(860) 354-7605
Fax
(860) 355-0089
NPI assigned
Nov 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 009807 CT Primary

Addresses

Primary practice location

130B Grove St
New Milford, CT 06776-3668

Mailing address

130B Grove St
New Milford, CT 06776-3668
Phone (860) 354-7605

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

LicenseStateTypeSpecialty
009807CTMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1383264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1346679271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130B GROVE ST",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067763668",
            "telephone_number": "860-354-7605",
            "fax_number": "860-355-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130B GROVE ST",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067763668",
            "telephone_number": "860-354-7605",
            "fax_number": "860-355-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANE",
        "first_name": "CECILIA",
        "middle_name": "J.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-01",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "009807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Milford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; 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.