Active NPI
Center for Physical Therapy & Sports Rehab
- Physical Therapist
- Groton, CT
National Provider Identifier
1538250642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1847
- Legal business name
- CENTER FOR PHYSICAL THERAPY & SPORTS REHAB
- Practice address
- 495 Gold Star Hwy
Suite 112
Groton, CT 06340-6803 - Phone
- (860) 446-8254
- Fax
- (860) 446-8293
- NPI assigned
- Sep 27, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gerdt Propfe Jr., PT
- Title
- Clinical Director
- Phone
- (860) 446-8254
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1847 | CT | Primary |
Addresses
Primary practice location
495 Gold Star Hwy
Suite 112
Groton, CT 06340-6803
Mailing address
495 Gold Star Hwy
Suite 112
Groton, CT 06340-6803
Phone (860) 446-8254
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0V1692 | Other | CT | HEALTH NET |
| 080001847CT01 | Other | CT | ANTHEM BLUE CROSS |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1538250642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "495 GOLD STAR HWY",
"address_2": "SUITE 112",
"city": "GROTON",
"state": "CT",
"postal_code": "063406803",
"telephone_number": "860-446-8254",
"fax_number": "860-446-8293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "495 GOLD STAR HWY",
"address_2": "SUITE 112",
"city": "GROTON",
"state": "CT",
"postal_code": "063406803",
"telephone_number": "860-446-8254",
"fax_number": "860-446-8293"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CENTER FOR PHYSICAL THERAPY & SPORTS REHAB",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-27",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "PROPFE",
"authorized_official_first_name": "GERDT",
"authorized_official_title_or_position": "CLINICAL DIRECTOR",
"authorized_official_telephone_number": "860-446-8254",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "PT"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "CT",
"license": "1847",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "0V1692",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "080001847CT01",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Groton, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.