NPIMap

Organization Active NPI

Primary Physical Therapy PLLC

Doing business as PROActive Physical Therapy

  • Physical Therapist
  • Cortland, NY
National Provider Identifier
1598088106
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PRIMARY PHYSICAL THERAPY PLLC
Doing business as
PROActive Physical Therapy
Practice address
1259 Fisher Ave
Cortland, NY 13045-1012
Phone
(607) 756-7991
Fax
(607) 756-5487
NPI assigned
Mar 10, 2010
Last updated
Jul 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Authorized official

Name
Jeffrey W Hathaway, PT
Title
Owner/PT
Phone
(315) 451-6541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

1259 Fisher Ave
Cortland, NY 13045-1012

Mailing address

5496 E Taft Rd
Ste 2
North Syracuse, NY 13212-3784
Phone (315) 451-6541

Other names 1

  • PROActive Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

5701 E Circle Dr
Cicero, NY 13039
Phone (315) 451-6541

3943 State Route 281
Cortland, NY 13045

6512 Wes Rd
Hamilton, NY 13346

4205 Long Branch Rd
Ste 8
Liverpool, NY 13090
Phone (315) 214-3431

7325 Oswego Rd
#57
Liverpool, NY 13090
Phone (315) 451-6541

140 W Seneca St
Manlius, NY 13104
Phone (315) 692-2336

5496 E Taft Rd
Ste 2
North Syracuse, NY 13212
Phone (315) 451-6541

792 N Main St
Ste 2
North Syracuse, NY 13212
Phone (315) 458-2552

125 W Main St
Waterville, NY 13480

358 Madison St
Waterville, NY 13480
Phone (315) 841-3222

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1268179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277942400000",
    "number": "1598088106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5496 E TAFT RD",
            "address_2": "STE 2",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132123784",
            "telephone_number": "315-451-6541",
            "fax_number": "315-451-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1259 FISHER AVE",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130451012",
            "telephone_number": "607-756-7991",
            "fax_number": "607-756-5487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-10",
        "last_updated": "2010-07-01",
        "status": "A",
        "authorized_official_last_name": "HATHAWAY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER/PT",
        "authorized_official_telephone_number": "315-451-6541",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROActive Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cortland, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; 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.