NPIMap

Organization Active NPI

Family Care Physicial Therapy

  • Physical Therapy Clinic/Center
  • Springfield, MA
National Provider Identifier
1639367295
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
7165 Issued in MA
Legal business name
FAMILY CARE PHYSICIAL THERAPY
Practice address
1515 Allen St
Springfield, MA 01118-1803
Phone
(413) 783-9114
Fax
(413) 782-6074
NPI assigned
Oct 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Authorized official

Name
Patricia Ann Detomas
Title
Financial Administrator
Phone
(413) 782-6074

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 7165 MA Primary

Addresses

Primary practice location

1515 Allen St
Springfield, MA 01118-1803

Mailing address

1515 Allen St
Springfield, MA 01118-1803
Phone (413) 783-9114

Other identifiers 1

IdentifierTypeStateIssuer
Y61118OtherMABLUE CROSS/BLUE SHIELD

National Provider Directory

National Provider Directory
Tax ID family
Urgent Care Physicians PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1515 Allen St
Springfield, MA 01118
Phone (413) 782-0030

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1639367295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 ALLEN ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011181803",
            "telephone_number": "413-783-9114",
            "fax_number": "413-782-6074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 ALLEN ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011181803",
            "telephone_number": "413-783-9114",
            "fax_number": "413-782-6074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE PHYSICIAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "DETOMAS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "FINANCIAL ADMINISTRATOR",
        "authorized_official_telephone_number": "413-782-6074"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MA",
            "license": "7165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "Y61118",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.