NPIMap

Organization Active NPI

Sandra J Uppvall, PT, LMT

Doing business as Northeast Physical Therapy Services

  • Specialist
  • Ithaca, NY
National Provider Identifier
1629290903
Registry record updated May 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
012344-1 Issued in NY
Legal business name
SANDRA J UPPVALL, PT, LMT
Doing business as
Northeast Physical Therapy Services
Practice address
111 Kay St
Ithaca, NY 14850-1703
Phone
(607) 257-2743
Fax
(607) 257-5809
NPI assigned
May 3, 2007
Last updated
May 7, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2017

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

Authorized official

Name
Ms. Sandra J. Uppvall, P.T.NPI 1902872609
Title
Sole Proprietor
Phone
(607) 257-2743

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 012344-1 NY Primary

Addresses

Primary practice location

111 Kay St
Ithaca, NY 14850-1703

Mailing address

111 Kay St
Ithaca, NY 14850-1703
Phone (607) 257-2743

Other names 1

  • Northeast Physical Therapy Services Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494115200000",
    "number": "1629290903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 KAY ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501703",
            "telephone_number": "607-257-2743",
            "fax_number": "607-257-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 KAY ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501703",
            "telephone_number": "607-257-2743",
            "fax_number": "607-257-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDRA J UPPVALL, PT, LMT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2017-05-07",
        "status": "A",
        "authorized_official_last_name": "UPPVALL",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "607-257-2743",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "012344-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Physical Therapy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2017; 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.