Active NPI
Tara Suzanne Garrett, MS PT CLT LA
- Physical Therapist
- Williamsville, NY
National Provider Identifier
1629141064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 014055
- Practice address
- 705 Maple Rd Ste 100
Williamsville, NY 14221-3291 - Phone
- (716) 580-7360
- Fax
- (716) 580-7396
- NPI assigned
- Nov 15, 2006
- Last updated
- Dec 2, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 014055-1 | NY | |
| Physical Therapist | 225100000X | 014055 | NY | Primary |
Addresses
Primary practice location
705 Maple Rd Ste 100
Williamsville, NY 14221-3291
Mailing address
705 Maple Rd Ste 100
Williamsville, NY 14221-3291
Phone (716) 805-7360
Other practice location 1
3915 Sheridan Drive
Amherst, NY 14226
Phone (716) 632-7465
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9312131 | Other | NY | INDEPENDENT HEALTH |
| 000627413001 | Other | NY | BLUE CROSS BLUE SHIELD |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014055-1 | NY | MD | Physical Therapist |
| 014055 | NY | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575244800000",
"number": "1629141064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "705 MAPLE RD STE 100",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142213291",
"telephone_number": "716-805-7360",
"fax_number": "716-580-7396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 MAPLE RD STE 100",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142213291",
"telephone_number": "716-580-7360",
"fax_number": "716-580-7396"
}
],
"practiceLocations": [
{
"address_1": "3915 Sheridan Drive",
"address_purpose": "LOCATION",
"city": "Amherst",
"state": "NY",
"postal_code": "14226",
"country_code": "US",
"telephone_number": "716-632-7465",
"fax_number": "716-632-7464",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GARRETT",
"first_name": "TARA",
"middle_name": "SUZANNE",
"name_prefix": "Mrs.",
"credential": "MS PT CLT LA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2019-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "014055-1",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "014055",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENT HEALTH",
"identifier": "9312131",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "000627413001",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williamsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.