CT Scoliosis and Spine Rehab, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

004216 Issued in CT

Legal business name

CT SCOLIOSIS AND SPINE REHAB, LLC

Practice address

871 Ethan Allen Hwy
Ste 104
Ridgefield, CT 06877-2800

Phone

(203) 431-0348

Fax

(203) 431-0351

NPI assigned

Sep 22, 2016

Organization subpart

No

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

Authorized official

Name

Gail Fennell, P.T.

Title

Physical Therapist/Owner

Phone

(203) 431-0348

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474502400000",
    "number": "1801345699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 ETHAN ALLEN HWY",
            "address_2": "STE. 104",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "06877",
            "telephone_number": "203-431-0348",
            "fax_number": "203-431-0351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 ETHAN ALLEN HWY",
            "address_2": "STE 104",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068772800",
            "telephone_number": "203-431-0348",
            "fax_number": "203-431-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CT SCOLIOSIS AND SPINE REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-22",
        "last_updated": "2016-09-22",
        "status": "A",
        "authorized_official_last_name": "FENNELL",
        "authorized_official_first_name": "GAIL",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "203-431-0348",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "004216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Cox-Lindenbaum
• Laura Susan Craighead, LCSW
• Shaunna M. Crockwell, PT
• Aaron Michael Crook
• Elysa Cruse
• Grace D'Onofrio, MS NCC LPC
• Jay D'Orso, MD
• James Adam Damascus, DDS
• Michelle Emma Damelio, OTD, OTR/L
• Dana C Jones DDS PC

• Physical Therapist in Ridgefield, CT
• Providers in Ridgefield, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; 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.