Physio-Lakeville, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PHYSIO-LAKEVILLE, LLC

Practice address

12 Sugar Hill Rd
Falls Village, CT 06031-1009

Phone

(860) 605-8783

NPI assigned

Jun 7, 2020

Last updated

Jun 7, 2020By 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

Ellen Walker, PT, DPT

Title

Owner

Phone

(860) 605-8783

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1591488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591488000000",
    "number": "1386268134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 SUGAR HILL RD",
            "city": "FALLS VILLAGE",
            "state": "CT",
            "postal_code": "060311009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 SUGAR HILL RD",
            "city": "FALLS VILLAGE",
            "state": "CT",
            "postal_code": "060311009",
            "telephone_number": "860-605-8783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIO-LAKEVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-07",
        "last_updated": "2020-06-07",
        "certification_date": "2020-06-07",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-605-8783",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Regional District 1

• Physical Therapist in Falls Village, CT
• Providers in Falls Village, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.