NPIMap

Organization Active NPI

Pediatric Physical Therapy Connection

  • Orthotist
  • Falmouth, ME
National Provider Identifier
1649280637
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OrthotistTaxonomy code 222Z00000X
License
C15212 Issued in MD
Legal business name
PEDIATRIC PHYSICAL THERAPY CONNECTION
Practice address
170 US Route One
Suite 180
Falmouth, ME 04105
Phone
(207) 781-5369
Fax
(207) 781-5862
NPI assigned
Aug 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

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

Authorized official

Name
Ms. Brenda Mattson, PT BOCONPI 1417967415
Title
Owner Physical Therapist Orthotist
Phone
(207) 781-5369

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
OrthotistGroup: 193200000X MULTI-SPECIALTY GROUP 222Z00000X C15212 MD Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT0512 ME
Customized Equipment (DME) 332BC3200X C15212 ME

Addresses

Primary practice location

170 US Route One
Suite 180
Falmouth, ME 04105

Mailing address

PO Box 66821
Falmouth, ME 04105-6821
Phone (207) 781-5369

Other identifiers 6

IdentifierTypeStateIssuer
1042321OtherAETNA
M23095OtherCIGNA
2434074OtherAETNA DME
M230950OtherCIGNA DME
018251OtherANTHEM BCBS
37938OtherHARVARD PILGRIM

Other names 1

  • Brenda Mattson Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1649280637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66821",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041056821",
            "telephone_number": "207-781-5369",
            "fax_number": "207-781-5862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 US ROUTE ONE",
            "address_2": "SUITE 180",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "04105",
            "telephone_number": "207-781-5369",
            "fax_number": "207-781-5862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PHYSICAL THERAPY CONNECTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "MATTSON",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "OWNER  PHYSICAL THERAPIST ORTHOTIST",
        "authorized_official_telephone_number": "207-781-5369",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT BOCO"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthotist",
            "state": "MD",
            "license": "C15212",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT0512",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "ME",
            "license": "C15212",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1042321",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "M23095",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA DME",
            "identifier": "2434074",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA DME",
            "identifier": "M230950",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "018251",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "37938",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brenda Mattson",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Falmouth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; 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.