Individual provider Active NPI

Ronald Weatherbee, PTA

  • Physical Therapy Assistant
  • Windsor, CT
National Provider Identifier
1356466874
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
000600 Issued in CT
Practice address
1 Emerson Dr
Windsor, CT 06095-3204
Phone
(860) 640-6338
Fax
(860) 285-8864
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 000600 CT Primary

Addresses

Primary practice location

1 Emerson Dr
Windsor, CT 06095-3204

Mailing address

29 Crestridge Dr
Vernon, CT 06066-4107
Phone (860) 838-2616

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

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356466874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 CRESTRIDGE DR",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664107",
            "telephone_number": "860-838-2616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EMERSON DR",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060953204",
            "telephone_number": "860-640-6338",
            "fax_number": "860-285-8864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERBEE",
        "first_name": "RONALD",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CT",
            "license": "000600",
            "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.

Verify at the official NPI Registry.