Individual provider Active NPI

Glen Angers, PT

  • Physical Therapist
  • Canton, CT
National Provider Identifier
1710128830
Registry record updated Mar 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
004328 Issued in CT
Practice address
65 Albany Tpke
Canton, CT 06019-2507
Phone
(860) 693-6226
Fax
(860) 693-8002
NPI assigned
Mar 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 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 004328 CT Primary

Addresses

Primary practice location

65 Albany Tpke
Canton, CT 06019-2507

Mailing address

PO Box 466
Canton, CT 06019-0466
Phone (860) 693-6226

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
004328CTMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Canton Physical Therapy, LLC Physical Therapist Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237420800000",
    "number": "1710128830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 466",
            "city": "CANTON",
            "state": "CT",
            "postal_code": "060190466",
            "telephone_number": "860-693-6226",
            "fax_number": "860-693-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 ALBANY TPKE",
            "city": "CANTON",
            "state": "CT",
            "postal_code": "060192507",
            "telephone_number": "860-693-6226",
            "fax_number": "860-693-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGERS",
        "first_name": "GLEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-19",
        "last_updated": "2009-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "004328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.