Active NPI
Kimberly Rose Martin, MSPT
- Physical Therapist
- East Haven, CT
National Provider Identifier
1720204472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 007839
- Practice address
- 451 N High St
East Haven, CT 06512-1555 - Phone
- (203) 466-6850
- NPI assigned
- Apr 18, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 007839 | CT | Primary |
Addresses
Primary practice location
451 N High St
East Haven, CT 06512-1555
Mailing address
410 Emmett St
Unit 43
Bristol, CT 06010-8600
Phone (860) 888-2397
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
| License | State | Type | Specialty |
|---|---|---|---|
| 007839 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720204472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 EMMETT ST",
"address_2": "UNIT 43",
"city": "BRISTOL",
"state": "CT",
"postal_code": "060108600",
"telephone_number": "860-888-2397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "451 N HIGH ST",
"city": "EAST HAVEN",
"state": "CT",
"postal_code": "065121555",
"telephone_number": "203-466-6850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "KIMBERLY",
"middle_name": "ROSE",
"name_prefix": "Mrs.",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "007839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.