Individual provider Active NPI

Joanna Fisher, DPT

  • Physical Therapist
  • Waterbury, CT
National Provider Identifier
1487108502
Registry record updated Aug 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11104 Issued in CT
Practice address
1211 W Main St
Waterbury, CT 06708-3106
Phone
(203) 753-6043
Fax
(203) 574-3127
NPI assigned
Aug 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 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 11104 CT Primary

Addresses

Primary practice location

1211 W Main St
Waterbury, CT 06708-3106

Mailing address

47 N Main St
West Hartford, CT 06107-1926
Phone (860) 409-4595

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
11104CTMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart University, Inc Physical Therapist Past Accepting new patients
Integrated Rehabilitation Services, LLC Physical Therapist PastSince Mar 18, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470355200000",
    "number": "1487108502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 N MAIN ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071926",
            "telephone_number": "860-409-4595",
            "fax_number": "860-409-4860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083106",
            "telephone_number": "203-753-6043",
            "fax_number": "203-574-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "JOANNA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-05",
        "last_updated": "2016-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "11104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.