Organization Active NPI

Sports Physical Therapy East, PC

  • Physical Therapist
  • Amagansett, NY
National Provider Identifier
1568540045
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SPORTS PHYSICAL THERAPY EAST, PC
Practice address
518 Montauk Hwy
Ste 101
Amagansett, NY 11930
Phone
(631) 267-9100
Fax
(631) 267-9111
NPI assigned
Nov 1, 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
Ms. Randi Beth Cherill, PT, ATC
Title
President
Phone
(631) 375-4626

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

518 Montauk Hwy
Ste 101
Amagansett, NY 11930

Mailing address

PO Box 1560
518 Montauk Hwy
Amagansett, NY 11930-1560
Phone (631) 267-9100

National Provider Directory

National Provider Directory

Locations

760 Montauk Hwy
Ctr Moriches, NY 11934
Phone (631) 874-4707

505 Montauk Hwy
Moriches, NY 11955
Phone (631) 874-4710

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568540045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1560",
            "address_2": "518 MONTAUK HWY",
            "city": "AMAGANSETT",
            "state": "NY",
            "postal_code": "119301560",
            "telephone_number": "631-267-9100",
            "fax_number": "631-267-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 MONTAUK HWY",
            "address_2": "STE 101",
            "city": "AMAGANSETT",
            "state": "NY",
            "postal_code": "11930",
            "telephone_number": "631-267-9100",
            "fax_number": "631-267-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS PHYSICAL THERAPY EAST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHERILL",
        "authorized_official_first_name": "RANDI",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-375-4626",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT, ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amagansett, NY

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.