Individual provider Active NPI

Robert A Rolston

  • Physical Therapy Assistant
  • North Branford, CT
National Provider Identifier
1497227763
Registry record updated Dec 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
001387
Practice address
104 Doral Farms Rd
North Branford, CT 06471-1136
Phone
(860) 395-7077
NPI assigned
Dec 26, 2018
Last updated
Dec 26, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 001387 Primary

Addresses

Primary practice location

104 Doral Farms Rd
North Branford, CT 06471-1136

Mailing address

104 Doral Farms Rd
North Branford, CT 06471-1136
Phone (860) 395-7077

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1497227763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 DORAL FARMS RD",
            "city": "NORTH BRANFORD",
            "state": "CT",
            "postal_code": "064711136",
            "telephone_number": "860-395-7077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 DORAL FARMS RD",
            "city": "NORTH BRANFORD",
            "state": "CT",
            "postal_code": "064711136",
            "telephone_number": "860-395-7077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLSTON",
        "first_name": "ROBERT",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-26",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": "001387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Branford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; 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.