NPIMap

Organization Active NPI

Unified Therapy, LLC

  • Pediatric Physical Therapist
  • South Windsor, CT
National Provider Identifier
1356884522
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
007148 Issued in CT
Legal business name
UNIFIED THERAPY, LLC
Practice address
869 Sullivan Ave
Suite 7
South Windsor, CT 06074-2007
Phone
(860) 644-2335
NPI assigned
Nov 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Authorized official

Name
Howard Gregory Venzie, DPT
Title
Physical Therapist/Owner
Phone
(860) 644-2335

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251P0200X 007148 CT Primary
Pediatric Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225XP0200X 4793 CT
Speech-Language PathologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 235Z00000X 002397 CT

Addresses

Primary practice location

869 Sullivan Ave
Suite 7
South Windsor, CT 06074-2007

Mailing address

915 Sullivan Ave Ste 3
South Windsor, CT 06074-2165
Phone (860) 644-2335

National Provider Directory

National Provider Directory

Locations

915 Sullivan Ave
Ste 3
South Windsor, CT 06074
Phone (860) 644-2335

869 Sullivan Ave
Ste 7
South Windsor, CT 06074
Phone (860) 644-2335

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1356884522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 SULLIVAN AVE STE 3",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742165",
            "telephone_number": "860-644-2335",
            "fax_number": "888-974-2148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "869 SULLIVAN AVE",
            "address_2": "SUITE 7",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742007",
            "telephone_number": "860-644-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIFIED THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-21",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "VENZIE",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "860-644-2335",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CT",
            "license": "007148",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CT",
            "license": "4793",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "002397",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Windsor, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; 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.