Farmington Valley Physical Therapy and Sports Medicine, PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

004916 Issued in CT

Legal business name

FARMINGTON VALLEY PHYSICAL THERAPY AND SPORTS MEDICINE, PC

Practice address

112 S Main St
Unionville, CT 06085-1255

Phone

(860) 673-0223

Fax

(860) 673-7605

NPI assigned

Feb 3, 2007

Last updated

Sep 20, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Boguslawa Jolanta Badon, RPTNPI 1750571782

Title

President

Phone

(860) 673-0223

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629116249. Details of each certification follow.

• CCN 076568 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 076568

Legal name

FARMINGTON VALLEY PHYSICAL THERAPY

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Jun 18, 1997

Last certification

Sep 8, 2023

Ownership / control type

Proprietary

Facility address

112 South Main Street
Unionville, CT 06085

Locations

Practitioners 2

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.

• Boguslawa Jolanta Badon, PHYSICAL THERAPIST

  • Specialist
  • Unionville, CT
  • NPI 1750571782
  NPD Authorized official
• Miriana Uniejewska

  • Specialist
  • Unionville, CT
  • NPI 1164690301
  NPD (past)

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190246400000",
    "number": "1629116249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 S MAIN ST",
            "city": "UNIONVILLE",
            "state": "CT",
            "postal_code": "060851255",
            "telephone_number": "860-673-0223",
            "fax_number": "860-673-7605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 S MAIN ST",
            "city": "UNIONVILLE",
            "state": "CT",
            "postal_code": "060851255",
            "telephone_number": "860-673-0223",
            "fax_number": "860-673-7605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARMINGTON VALLEY PHYSICAL THERAPY AND SPORTS MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-03",
        "last_updated": "2007-09-20",
        "status": "A",
        "authorized_official_last_name": "BADON",
        "authorized_official_first_name": "BOGUSLAWA",
        "authorized_official_middle_name": "JOLANTA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-673-0223",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CT",
            "license": "004916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emilia Croteau
• Karen Q Dang, RPH
• Simone A De Groot, PHARMD
• Concetta D'Agostino Dufresne, LMFT
• Emerging Recovery, LLC
• Kenneth J Fisher, RPH
• Allison Kathleen Gibney, BCBA
• Mark Nicholson Gilroy, D.O.
• Margherita R. Giuliano, R.PH.
• Katelyn Graves, PA-C

• Physical Therapy Clinic/Center in Unionville, CT
• Providers in Unionville, CT by specialty
• Physical Therapy Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.