Individual provider Active NPI

Timothy Lindsay Durant, MSPT

  • Physical Therapist
  • Glastonbury, CT
National Provider Identifier
1578649356
Registry record updated Apr 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
005973 Issued in CT
Practice address
2928 Main St
Glastonbury, CT 06033-1007
Phone
(860) 430-2344
Fax
(860) 430-2349
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 005973 CT Primary

Addresses

Primary practice location

2928 Main St
Glastonbury, CT 06033-1007

Mailing address

8286 Wolcott Hill Road
Suite 102
Wethersfield, CT 06109
Phone (860) 436-2252

Other identifiers 4

IdentifierTypeStateIssuer
2V7374OtherHEATHNET
080005973CT22OtherBCBS
574277OtherAETNA
7496257OtherCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050222000979 CT Practitioner - Physical Therapist in Private Practice 9739132457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Timothy Durant Physical Therapy LLCGroup PAC ID 5395844831, 4 clinicians

Practice addresses (Care Compare)

2928 Main St
Suite 2
Glastonbury, CT 06033-1007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005973CTMDClinical Social Worker
5973CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy Durant Physical Therapy LLC CurrentSince Mar 1, 2005 Accepting new patients
Carbone Chiropractic Center Dba Southside Physical Therapy LLC Physical Therapist Past Accepting new patients

Locations

2928 Main St
Ste 2
Glastonbury, CT 06033
Phone (860) 430-2344

82-86 Wolcott Hill Rd
Ste 102
Wethersfield, CT 06109
Phone (860) 436-2252

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1578649356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8286 WOLCOTT HILL ROAD",
            "address_2": "SUITE 102",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "06109",
            "telephone_number": "860-436-2252",
            "fax_number": "860-436-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2928 MAIN ST",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331007",
            "telephone_number": "860-430-2344",
            "fax_number": "860-430-2349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURANT",
        "first_name": "TIMOTHY",
        "middle_name": "LINDSAY",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "005973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEATHNET",
            "identifier": "2V7374",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "080005973CT22",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "574277",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7496257",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.