Organization Active NPI

Center for Physical Therapy & Sports Rehab

  • Physical Therapist
  • Groton, CT
National Provider Identifier
1538250642
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1847 Issued in CT
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

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
0V1692OtherCTHEALTH NET
080001847CT01OtherCTANTHEM BLUE CROSS

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.