Individual provider Active NPI

Timothy Paul Loughlin, DPT

  • Physical Therapist
  • Smithfield, RI
National Provider Identifier
1700100476
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT03254 Issued in RI
Practice address
300 George Washington Hwy
Smithfield, RI 02917-1918
Phone
(401) 372-7611
Fax
(844) 579-0091
NPI assigned
Mar 24, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT03254 RI Primary
Physical Therapist 225100000X 23203 MD

Addresses

Primary practice location

300 George Washington Hwy
Smithfield, RI 02917-1918

Mailing address

21 Harkness Rd
North Smithfield, RI 02896-7727
Phone (774) 274-0669

Other practice location 1

1777 Reisterstown Road
Suite 130 East
Pikesville, MD 21208
Phone (410) 415-5905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201013001186 RI Practitioner - Physical Therapist in Private Practice 5698954477 Reassigns benefits to 1 organization
I20220419001393 MA Practitioner - Physical Therapist in Private Practice 5698954477 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

816 Middle Rd
Unit 3
East Greenwich, RI 02818-1826
Phone (401) 372-7611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23203MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Mar 7, 2022 Accepting new patients
Aspire Sports Medicine Inc Physical Therapist CurrentSince Nov 9, 2022 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Mar 7, 2022 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33377 Collection Ctr Dr
Chicago, IL 60693
Phone (617) 284-9418

101 University Dr
Ste A6
Amherst, MA 01002
Phone (413) 336-5703

74 Taunton St
Ste 202
Plainville, MA 02762
Phone (508) 316-1411

348 Cooley St
Unit 10
Springfield, MA 01128
Phone (413) 355-5700

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1700100476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 HARKNESS RD",
            "city": "NORTH SMITHFIELD",
            "state": "RI",
            "postal_code": "028967727",
            "telephone_number": "774-274-0669",
            "fax_number": "774-274-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GEORGE WASHINGTON HWY",
            "city": "SMITHFIELD",
            "state": "RI",
            "postal_code": "029171918",
            "telephone_number": "401-372-7611",
            "fax_number": "844-579-0091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1777 Reisterstown Road",
            "address_2": "Suite 130 East",
            "address_purpose": "LOCATION",
            "city": "Pikesville",
            "state": "MD",
            "postal_code": "21208",
            "country_code": "US",
            "telephone_number": "410-415-5905",
            "fax_number": "410-415-5906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOUGHLIN",
        "first_name": "TIMOTHY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-24",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT03254",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23203",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithfield, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.