Active NPI
Patrick J Teevan, DPT
- Physical Therapist
- Cromwell, CT
National Provider Identifier
1740812965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 12566
- Practice address
- 80 Shunpike Rd
Cromwell, CT 06416-4401 - Phone
- (860) 632-1792
- NPI assigned
- Feb 5, 2020
- Sex
- Male
- 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 | 12566 | CT | Primary |
Addresses
Primary practice location
80 Shunpike Rd
Cromwell, CT 06416-4401
Mailing address
228 Pheasant Run
Newington, CT 06111-3726
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12566 | CT | MD | Clinical Social Worker |
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.
-
- Physical Therapist
- Wolcott, CT
- NPI 1861677262
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580860800000",
"number": "1740812965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "228 PHEASANT RUN",
"city": "NEWINGTON",
"state": "CT",
"postal_code": "061113726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 SHUNPIKE RD",
"city": "CROMWELL",
"state": "CT",
"postal_code": "064164401",
"telephone_number": "860-632-1792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEEVAN",
"first_name": "PATRICK",
"middle_name": "J",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-05",
"last_updated": "2020-02-05",
"certification_date": "2020-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "12566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cromwell, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.