Individual provider Active NPI

Sally Kappen, MPT

  • Physical Therapist
  • Ridgefield, CT
National Provider Identifier
1780907758
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT016659 Issued in OH
Practice address
10 South St
Suite 105
Ridgefield, CT 06877-4124
Phone
(203) 431-7632
Fax
(203) 431-9259
NPI assigned
Mar 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT016659 OH Primary

Addresses

Primary practice location

10 South St
Suite 105
Ridgefield, CT 06877-4124

Mailing address

6560 Centerville Business Pkwy
Centerville, OH 45459-2685
Phone (937) 470-7612

Other identifiers 1

IdentifierTypeStateIssuer
1114979226OtherCTANTHEM BLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201001002897 OH Practitioner - Physical Therapist in Private Practice 5294742607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ortho Advantage LLCGroup PAC ID 3577566579, 8 clinicians

Practice addresses (Care Compare)

8200 Washington Village Dr
Centerville, OH 45458-1850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
April D. Dunnington, Inc. CurrentSince Oct 4, 2020 Accepting new patients
Ortho Advantage LLC Physical Therapist CurrentSince Oct 1, 2020 Accepting new patients
Optimal Health & Movement, LLC Current Accepting new patients
Premier Physical Therapy Sport Medicine Inc Physical Therapist Past Accepting new patients

Locations

6560 Centerville Business Pkwy
Dayton, OH 45459
Phone (937) 432-6565

8200 Washington Village Dr
Dayton, OH 45458
Phone (937) 434-4141

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1267747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1780907758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6560 CENTERVILLE BUSINESS PKWY",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454592685",
            "telephone_number": "937-470-7612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SOUTH ST",
            "address_2": "SUITE 105",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068774124",
            "telephone_number": "203-431-7632",
            "fax_number": "203-431-9259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPPEN",
        "first_name": "SALLY",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-05",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT016659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "1114979226",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.