Individual provider Active NPI

Christine Baribeau Volavka, P.T.

  • Physical Therapist
  • Bay Shore, NY
National Provider Identifier
1396886446
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
012046-1 Issued in NY
Practice address
1391 Peters Blvd
Bay Shore, NY 11706-4847
Phone
(631) 666-2587
Fax
(631) 666-2587
NPI assigned
Feb 10, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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 Therapist 225100000X 012046-1 NY Primary

Addresses

Primary practice location

1391 Peters Blvd
Bay Shore, NY 11706-4847

Mailing address

1391 Peters Blvd
Bay Shore, NY 11706-4847
Phone (631) 666-2587

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

State licenses

LicenseStateTypeSpecialty
012046-1NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1171065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396886446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1391 PETERS BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064847",
            "telephone_number": "631-666-2587",
            "fax_number": "631-666-2587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1391 PETERS BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064847",
            "telephone_number": "631-666-2587",
            "fax_number": "631-666-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOLAVKA",
        "first_name": "CHRISTINE",
        "middle_name": "BARIBEAU",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "012046-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

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.