NPIMap

Organization Active NPI

Physical Therapy Center of Bristol, LLC

Doing business as FYZICAL Therapy & Balance Center

  • Physical Therapy Clinic/Center
  • Bristol, CT
National Provider Identifier
1396893590
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PHYSICAL THERAPY CENTER OF BRISTOL, LLC
Doing business as
FYZICAL Therapy & Balance Center
Practice address
72 Pine St
Bristol, CT 06010-6960
Phone
(860) 585-5800
Fax
(860) 585-5840
NPI assigned
Jan 7, 2007
Last updated
Aug 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Authorized official

Name
Eric Eldon Douglass, PT
Title
Chief Clinical Officer
Phone
(941) 870-4401

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

72 Pine St
Bristol, CT 06010-6960

Mailing address

PO Box 632665
Cincinnati, OH 45263-2665
Phone (702) 818-5000

Other practice location 1

1 Dan Fox Dr
Pittsfield, MA 01201-8234
Phone (413) 337-3674

Other practice location 2

1090 Meriden Waterbury Tpke
Plantsville, CT 06479-2055
Phone (203) 272-8490

Other names 1

  • FYZICAL Therapy & Balance Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040205001043 CT Part B Supplier - Clinic/Group Practice 4385537075 Receives reassigned benefits from 6 practitioners
Practice locations: Bristol, CT; Plantsville, CT
O20220321000175 MA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4385537075 Receives reassigned benefits from 2 practitioners
Practice locations: Pittsfield, MA

National Provider Directory

National Provider Directory

Locations

72 Pine St
Bristol, CT 06010
Phone (860) 585-5800

72 Pine St
Unit A
Bristol, CT 06010
Phone (860) 585-5800

1090 Meriden Waterbury Tpke
Plantsville, CT 06479
Phone (203) 272-8490

20 Chapel St
Wallingford, CT 06492
Phone (203) 741-9948

1 Dan Fox Dr
Pittsfield, MA 01201
Phone (413) 337-3674

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1168128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755734400000",
    "number": "1396893590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632665",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632665",
            "telephone_number": "702-818-5000",
            "fax_number": "702-818-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 PINE ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060106960",
            "telephone_number": "860-585-5800",
            "fax_number": "860-585-5840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Dan Fox Dr",
            "address_purpose": "LOCATION",
            "city": "Pittsfield",
            "state": "MA",
            "postal_code": "012018234",
            "country_code": "US",
            "telephone_number": "413-337-3674",
            "fax_number": "413-442-9701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1090 Meriden Waterbury Tpke",
            "address_purpose": "LOCATION",
            "city": "Plantsville",
            "state": "CT",
            "postal_code": "064792055",
            "country_code": "US",
            "telephone_number": "203-272-8490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHYSICAL THERAPY CENTER OF BRISTOL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-07",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A",
        "authorized_official_last_name": "DOUGLASS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "ELDON",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "941-870-4401",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FYZICAL Therapy & Balance Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bristol, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.