Organization Active NPI

Farmington Valley Physical Therapy and Sports Medicine, PC

  • Physical Therapy Clinic/Center
  • Unionville, CT
National Provider Identifier
1629116249
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 004916 CT Primary

Addresses

Primary practice location

112 S Main St
Unionville, CT 06085-1255

Mailing address

112 S Main St
Unionville, CT 06085-1255
Phone (860) 673-0223

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060320000116 CT Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 7416964234 Practice locations: Unionville, CT

National Provider Directory

National Provider Directory

Locations

112 S Main St
Unionville, CT 06085
Phone (860) 673-0223

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": "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": []
}

Other providers in Unionville, CT

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.