Individual provider Active NPI

Judith W Spafford

  • Physical Therapist
  • Liberty, NY
National Provider Identifier
1699098624
Registry record updated Mar 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
010276-1 Issued in NY
Practice address
256 Sunset Lake Rd
Liberty, NY 12754
Phone
(845) 292-8640
NPI assigned
Mar 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 010276-1 NY Primary

Addresses

Primary practice location

256 Sunset Lake Rd
Liberty, NY 12754

Mailing address

9 Hillside Ave
Liberty, NY 12754
Phone (845) 292-3621

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

State licenses

LicenseStateTypeSpecialty
010276-1NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1699098624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 HILLSIDE AVE",
            "city": "LIBERTY",
            "state": "NY",
            "postal_code": "12754",
            "telephone_number": "845-292-3621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 SUNSET LAKE RD",
            "city": "LIBERTY",
            "state": "NY",
            "postal_code": "12754",
            "telephone_number": "845-292-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAFFORD",
        "first_name": "JUDITH",
        "middle_name": "W",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-04",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "010276-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; 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.