Individual provider Active NPI

Darryl White, MS,PT

  • Physical Therapist
  • Waterbury, CT
National Provider Identifier
1710117718
Registry record updated Jul 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
008585 Issued in CT
Practice address
47 Vernon St
Waterbury, CT 06708-3008
Phone
(203) 753-6043
Fax
(203) 574-3127
NPI assigned
Jul 24, 2009
Last updated
Jul 24, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2009

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 008585 CT Primary

Addresses

Primary practice location

47 Vernon St
Waterbury, CT 06708-3008

Mailing address

270 Farmington Ave
Suite 303
Farmington, CT 06032-1909
Phone (860) 409-4595

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
008585CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Services, LLC Physical Therapist PastSince Mar 18, 2019 Accepting new patients
Norwich Orthopedic Group, P.C. Physical Therapist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248393600000",
    "number": "1710117718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 FARMINGTON AVE",
            "address_2": "SUITE 303",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321909",
            "telephone_number": "860-409-4595",
            "fax_number": "860-409-4860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 VERNON ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083008",
            "telephone_number": "203-753-6043",
            "fax_number": "203-574-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "DARRYL",
        "credential": "MS,PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-24",
        "last_updated": "2009-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "008585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2009; 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.