Pathways Physical Therapy,LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

006419 Issued in CT

Legal business name

PATHWAYS PHYSICAL THERAPY,LLC

Practice address

241 Broad St
Meriden, CT 06450-5877

Phone

(203) 440-9880

Fax

(203) 440-9881

NPI assigned

Jul 12, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Kelly Jean Anetrella, P.T.

Title

Owner

Phone

(203) 440-9880

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 1

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

• Kelly Jean Anetrellla, P.T.

  • Physical Therapist
  • Meriden, CT
  • NPI 1255367520
  Medicare reassignment NPD

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219363200000",
    "number": "1417156399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 BROAD ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064505877",
            "telephone_number": "203-440-9880",
            "fax_number": "203-440-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 BROAD ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064505877",
            "telephone_number": "203-440-9880",
            "fax_number": "203-440-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAYS PHYSICAL THERAPY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-12",
        "last_updated": "2008-08-22",
        "status": "A",
        "authorized_official_last_name": "ANETRELLA",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-440-9880",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CT",
            "license": "006419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORTHONET PROVIDER IDENTIFIER",
            "identifier": "0400870",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER ID",
            "identifier": "080006419CT05",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "C03722",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID",
            "identifier": "7285170",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET PROVIDER ID",
            "identifier": "XV0104",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dipak N Patel, D.O.
• Komal Patel, PHARMD
• Krishna Jaydev Patel, M.D.
• Priya P Patel, DDS
• Path of Life Counseling, LLC
• Regina Danehy Paulhus, CRNA
• Joshua Jose Pena, LPC-A
• Rebecca Pendakiwskyj
• Vincent Hoyt Pepe, MD
• Yashira Perdomo

• Physical Therapy Clinic/Center in Meriden, CT
• Providers in Meriden, CT by specialty
• Physical Therapy Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2008; 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.