Individual provider Active NPI

Gerdt Propfe Jr., PT

  • Physical Therapist
  • Watertown, CT
National Provider Identifier
1376753095
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1847 Issued in CT
Practice address
27 Depot St
Watertown, CT 06795-2601
Phone
(860) 274-4092
Fax
(860) 274-4099
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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 1847 CT Primary

Addresses

Primary practice location

27 Depot St
Watertown, CT 06795-2601

Mailing address

495 Gold Star Hwy
Suite 112
Groton, CT 06340-6228
Phone (860) 446-8254

Other identifiers 1

IdentifierTypeStateIssuer
080001847CT02OtherCTANTHEM BC BS

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
1847CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart University, Inc Physical Therapist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1376753095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 GOLD STAR HWY",
            "address_2": "SUITE 112",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063406228",
            "telephone_number": "860-446-8254",
            "fax_number": "860-446-8293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 DEPOT ST",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067952601",
            "telephone_number": "860-274-4092",
            "fax_number": "860-274-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROPFE",
        "first_name": "GERDT",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "1847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS",
            "identifier": "080001847CT02",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.