NPIMap

Organization Active NPI

Proactive Physical Therapy, Inc.

  • Physical Therapist
  • Narragansett, RI
National Provider Identifier
1780758458
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROACTIVE PHYSICAL THERAPY, INC.
Practice address
140 Point Judith Rd
Suite #33
Narragansett, RI 02882-3451
Phone
(401) 789-2077
Fax
(401) 782-4762
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Erica M West, P.T.NPI 1588616684
Title
Owner
Phone
(401) 789-2077

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X RI Primary

Addresses

Primary practice location

140 Point Judith Rd
Suite #33
Narragansett, RI 02882-3451

Mailing address

140 Point Judith Rd
Suite #33
Narragansett, RI 02882-3451
Phone (401) 789-2077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040218000270 RI Part B Supplier - Clinic/Group Practice 9537054648 Receives reassigned benefits from 8 practitioners
Practice locations: Narragansett, RI

National Provider Directory

National Provider Directory

Locations

140 Point Judith Rd
#47
Narragansett, RI 02882
Phone (401) 789-2077

140 Point Judith Rd
Ste 33
Narragansett, RI 02882
Phone (401) 789-2077

140 Point Judith Rd
Ste C47
Narragansett, RI 02882

140 Point Judith Rd
Ste 47
Point Judith, RI 02882
Phone (401) 789-2077

24 Salt Pond Rd
Ste E1
Wakefield, RI 02879
Phone (401) 783-0410

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780758458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 POINT JUDITH RD",
            "address_2": "SUITE #33",
            "city": "NARRAGANSETT",
            "state": "RI",
            "postal_code": "028823451",
            "telephone_number": "401-789-2077",
            "fax_number": "401-782-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 POINT JUDITH RD",
            "address_2": "SUITE #33",
            "city": "NARRAGANSETT",
            "state": "RI",
            "postal_code": "028823451",
            "telephone_number": "401-789-2077",
            "fax_number": "401-782-4762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-789-2077",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Narragansett, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.