Individual provider Active NPI

Chantal Sigouin Wilton, PHYSICAL THERAPIST

  • Specialist
  • Watertown, NY
National Provider Identifier
1578545661
Registry record updated Dec 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
19870 Issued in NY
Practice address
26515 Nys RT 3
Watertown, NY 13601-1749
Phone
(315) 408-6023
Fax
(315) 782-0002
NPI assigned
Nov 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 19870 NY Primary

Addresses

Primary practice location

26515 Nys RT 3
Watertown, NY 13601-1749

Mailing address

25411 Miller Rd
Watertown, NY 13601-5055
Phone (315) 782-0002

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
19870NYMDClinical Social Worker
019870NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260316800000",
    "number": "1578545661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25411 MILLER RD",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136015055",
            "telephone_number": "315-782-0002",
            "fax_number": "315-883-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26515 NYS RT 3",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011749",
            "telephone_number": "315-408-6023",
            "fax_number": "315-782-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILTON",
        "first_name": "CHANTAL",
        "middle_name": "SIGOUIN",
        "name_prefix": "Mrs.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2009-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "19870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; 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.