NPIMap

Organization Active NPI

Fall Mountain Physical Therapy and Athletic Training, PLLC

  • Physical Therapist
  • Langdon, NH
National Provider Identifier
1417047689
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2994 Issued in NH
Legal business name
FALL MOUNTAIN PHYSICAL THERAPY AND ATHLETIC TRAINING, PLLC
Practice address
122 NH Route 12a
Langdon, NH 03602-8221
Phone
(603) 835-7828
Fax
(603) 835-7827
NPI assigned
Oct 16, 2006
Last updated
Nov 29, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Authorized official

Name
Mrs. Lisa N Young, MPT, ATCNPI 1386669828
Title
Owner, PT, Atc
Phone
(603) 835-7828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2994 NH Primary
Athletic Trainer 2255A2300X 0036 NH

Addresses

Primary practice location

122 NH Route 12a
Langdon, NH 03602-8221

Mailing address

PO Box 57
Alstead, NH 03602-0057
Phone (603) 835-7828

Other identifiers 5

IdentifierTypeStateIssuer
08Y007675NH03OtherNHANTHEM BCBS
30394477MedicaidNH
DF1145OtherNHRAILROAD MEDICARE
6007380OtherNHMVP
AA65774OtherNHHARVARD PILGRIM

Other names 1

  • FMPTAT Other name

National Provider Directory

National Provider Directory

Locations

122 NH Route 12A
Langdon, NH 03602
Phone (603) 835-0006

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1417047689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 57",
            "city": "ALSTEAD",
            "state": "NH",
            "postal_code": "036020057",
            "telephone_number": "603-835-7828",
            "fax_number": "603-835-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 NH ROUTE 12A",
            "city": "LANGDON",
            "state": "NH",
            "postal_code": "036028221",
            "telephone_number": "603-835-7828",
            "fax_number": "603-835-7827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALL MOUNTAIN PHYSICAL THERAPY AND ATHLETIC TRAINING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER, PT, ATC",
        "authorized_official_telephone_number": "603-835-7828",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MPT, ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "2994",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NH",
            "license": "0036",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "08Y007675NH03",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30394477",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF1145",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "6007380",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA65774",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FMPTAT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Langdon, NH

Sources for this page

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