NPIMap

Organization Active NPI

Cheshire Physical Therapy & Sports Medicine, Inc

  • Specialist
  • Cheshire, CT
National Provider Identifier
1669690087
Registry record updated Nov 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
02770 Issued in CT
Legal business name
CHESHIRE PHYSICAL THERAPY & SPORTS MEDICINE, INC
Practice address
475 S Main St
Cheshire, CT 06410-3164
Phone
(203) 271-2928
Fax
(203) 699-8445
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2016

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

Authorized official

Name
John Payne, PT
Title
Owner
Phone
(203) 271-2928

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 02770 CT Primary

Addresses

Primary practice location

475 S Main St
Cheshire, CT 06410-3164

Mailing address

475 S Main St
Cheshire, CT 06410-3164
Phone (203) 271-2928

Other identifiers 2

IdentifierTypeStateIssuer
004232469MedicaidCT
225100000XOtherCTTAXONOMY - NPPES

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478822400000",
    "number": "1669690087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 S MAIN ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103164",
            "telephone_number": "203-271-2928",
            "fax_number": "203-699-8445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 S MAIN ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103164",
            "telephone_number": "203-271-2928",
            "fax_number": "203-699-8445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESHIRE PHYSICAL THERAPY & SPORTS MEDICINE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2016-11-11",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-271-2928",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CT",
            "license": "02770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004232469",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY - NPPES",
            "identifier": "225100000X",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheshire, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2016; 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.