NPIMap

Organization Active NPI

Optimal Performance Therapy

  • Physical Therapy Clinic/Center
  • Vernon, CT
National Provider Identifier
1407090475
Registry record updated Apr 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
006488 Issued in CT
Legal business name
OPTIMAL PERFORMANCE THERAPY
Practice address
18 Old Town Rd
Vernon, CT 06066-2308
Phone
(860) 268-3226
Fax
(860) 499-5356
NPI assigned
Apr 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2009

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

Authorized official

Name
Angela St. Louis, PT
Title
Owner
Phone
(860) 268-3226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 006488 CT Primary

Addresses

Primary practice location

18 Old Town Rd
Vernon, CT 06066-2308

Mailing address

18 Old Town Rd
Vernon, CT 06066-2308
Phone (860) 268-3226

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240272000000",
    "number": "1407090475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 OLD TOWN RD",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060662308",
            "telephone_number": "860-268-3226",
            "fax_number": "860-499-5356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 OLD TOWN RD",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060662308",
            "telephone_number": "860-268-3226",
            "fax_number": "860-499-5356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL PERFORMANCE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-21",
        "last_updated": "2009-04-21",
        "status": "A",
        "authorized_official_last_name": "ST. LOUIS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-268-3226",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CT",
            "license": "006488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; 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.