Kristen Ann Wulfing, DPT
Individual provider Active NPI Physical Therapist · South Windsor, CT
NPI 1427313683 · NPPES record last updated Mar 8, 2016
Key facts
- NPI
- 1427313683
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 009456 (CT)
- Practice address
- 1350 Sullivan Ave
South Windsor, CT 06074-2760 - Phone
- (860) 697-6472
- Fax
- (860) 648-2876
- NPI assigned
- Jul 12, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pinnacle Rehabilitation Network LLC
Practice addresses (Care Compare)
1350 Sullivan Ave
South Windsor, CT 06074-2760
Phone (860) 697-6472
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160404000524 | CT | Practitioner - Physical Therapist in Private Practice | 0941454078 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009456 | CT | MD | General Practice Dentistry |
| P14025 | NC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pinnacle Rehabilitation Network, LLC | Physical Therapist | Current |
Accepting new patients |
| Breakthrough Physical Therapy | Physical Therapist | Past | Accepting new patients |
Locations
1350 Sullivan Ave
South Windsor, CT 06074
Phone (860) 644-6525
73 Newton Rd
Unit 101
Plaistow, NH 03865
Phone (978) 388-7272
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 009456 | CT | Yes |
| Physical Therapist | 225100000X | P14025 | NC |
Addresses
Primary practice location
1350 Sullivan Ave
South Windsor, CT 06074-2760
Mailing address
73 Newton Rd
Ste 101
Plaistow, NH 03865-2424
Phone (978) 388-7272
Other names
- Kristen Ann Fontanella
Other providers in South Windsor, CT
- Williams Counseling
- Suzylynne Williams
- Jennifer Lynn Wilson
- Windsor Park Family Medicine, LLC
- Sheena Robbins Wraight
- John D Wysocki
- Chandra Yellinedi
- Your Nutri Guru
- Youth & Family Counseling, LLC
- Katrina Zaffetti
All providers in South Windsor, CT · Physical Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.