Pro Physical Therapy & Sportscare, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8100 Issued in MA

Legal business name

PRO PHYSICAL THERAPY & SPORTSCARE, INC.

Practice address

350 Fall River Ave
Seekonk, MA 02771-5506

Phone

(508) 336-3121

Fax

(508) 336-3120

NPI assigned

Apr 25, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Richard P Leclaire, PT

Title

Owner and Physical Therapist

Phone

(508) 336-3121

Specialties & licenses 2

Addresses

Other identifiers 9

Locations

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290470400000",
    "number": "1760601942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 FALL RIVER AVE",
            "city": "SEEKONK",
            "state": "MA",
            "postal_code": "027715506",
            "telephone_number": "508-336-3121",
            "fax_number": "508-336-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 FALL RIVER AVE",
            "city": "SEEKONK",
            "state": "MA",
            "postal_code": "027715506",
            "telephone_number": "508-336-3121",
            "fax_number": "508-336-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO PHYSICAL THERAPY & SPORTSCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2010-11-23",
        "status": "A",
        "authorized_official_last_name": "LECLAIRE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER AND PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "508-336-3121",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "8100",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT00460",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MA",
            "identifier": "Y61010",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD RI",
            "identifier": "2520-9",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "402383",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE VALUE MGMT",
            "identifier": "43142951",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "64-00067",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "608183",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "605708",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR ACS",
            "identifier": "102722300",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PR35723",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; 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.