Individual provider Active NPI

Stephanie Belanger, DPT

  • Physical Therapist
  • Middletown, CT
National Provider Identifier
1417314253
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
010724 Issued in CT
Practice address
410 Saybrook Rd
Suite 100
Middletown, CT 06457-4777
Phone
(860) 685-8940
Fax
(860) 685-8944
NPI assigned
Jan 25, 2016
Last updated
Jan 25, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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 010724 CT Primary

Addresses

Primary practice location

410 Saybrook Rd
Suite 100
Middletown, CT 06457-4777

Mailing address

410 Saybrook Road
Suite 100
Middletown, CT 06457-4780
Phone (860) 685-8940

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
010724CTMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1417314253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 SAYBROOK ROAD",
            "address_2": "SUITE 100",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574780",
            "telephone_number": "860-685-8940",
            "fax_number": "860-685-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 SAYBROOK RD",
            "address_2": "SUITE 100",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574777",
            "telephone_number": "860-685-8940",
            "fax_number": "860-685-8944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELANGER",
        "first_name": "STEPHANIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "010724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.