Active NPI
Roberta Nole, MAPT, CPED
- Physical Therapist
- Middlebury, CT
National Provider Identifier
1700064979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 003621
- Practice address
- 80 Turnpike Dr
Unit 1
Middlebury, CT 06762-1830 - Phone
- (203) 758-8307
- Fax
- (203) 758-8394
- NPI assigned
- Feb 9, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotic Fitter | 225000000X | |||
| Physical Therapist | 225100000X | 003621 | CT | Primary |
Addresses
Primary practice location
80 Turnpike Dr
Unit 1
Middlebury, CT 06762-1830
Mailing address
80 Turnpike Dr
Unit 1
Middlebury, CT 06762-1830
Phone (203) 758-8307
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12DME0603CT01 | Other | CT | ANTHEM BLUE CROSS BLUE SHIELD |
| 004137338 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stride Physical Therapy and Pedorthic Center, PC | Physical Therapist | Current | Accepting new patients |
Locations
80 Turnpike Dr
Ste 1
Middlebury, CT 06762
Phone (203) 758-8307
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Durable Medical Equipment & Medical Supplies
- Middlebury, CT
- NPI 1518088723
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233273600000",
"number": "1700064979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 TURNPIKE DR",
"address_2": "UNIT 1",
"city": "MIDDLEBURY",
"state": "CT",
"postal_code": "067621830",
"telephone_number": "203-758-8307",
"fax_number": "203-758-8394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 TURNPIKE DR",
"address_2": "UNIT 1",
"city": "MIDDLEBURY",
"state": "CT",
"postal_code": "067621830",
"telephone_number": "203-758-8307",
"fax_number": "203-758-8394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLE",
"first_name": "ROBERTA",
"credential": "MAPT, CPED",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-09",
"last_updated": "2009-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "225000000X",
"taxonomy_group": "",
"desc": "Orthotic Fitter",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "003621",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS BLUE SHIELD",
"identifier": "12DME0603CT01",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004137338",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Middlebury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.