NPIMap

Organization Active NPI

Finger Lakes Physical Therapy PC

  • Specialist
  • Ithaca, NY
National Provider Identifier
1720034093
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
FINGER LAKES PHYSICAL THERAPY PC
Practice address
376 Elmira Rd Ste 100
Ithaca, NY 14850-5115
Phone
(607) 272-9937
Fax
(888) 978-4495
NPI assigned
May 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Authorized official

Name
Kristine Walker, PT
Title
Owner
Phone
(607) 272-9337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

376 Elmira Rd Ste 100
Ithaca, NY 14850-5115

Mailing address

24 Main St
Freeville, NY 13068-9806
Phone (607) 272-9937

Other practice location 1

24 Main St
Freeville, NY 13068-9806
Phone (607) 272-9937

Other identifiers 2

IdentifierTypeStateIssuer
01758694MedicaidNM
01905595MedicaidNY

National Provider Directory

National Provider Directory

Locations

380 Pine Tree Rd
Ithaca, NY 14850
Phone (607) 277-0200

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626652800000",
    "number": "1720034093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 MAIN ST",
            "city": "FREEVILLE",
            "state": "NY",
            "postal_code": "130689806",
            "telephone_number": "607-272-9937",
            "fax_number": "888-978-4495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 ELMIRA RD STE 100",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505115",
            "telephone_number": "607-272-9937",
            "fax_number": "888-978-4495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Main St",
            "address_purpose": "LOCATION",
            "city": "Freeville",
            "state": "NY",
            "postal_code": "130689806",
            "country_code": "US",
            "telephone_number": "607-272-9937",
            "fax_number": "888-978-4495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FINGER LAKES PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-272-9337",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01758694",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01905595",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.