Individual provider Active NPI

Colin Ketchel, DPT

  • Physical Therapist
  • Branford, CT
National Provider Identifier
1801540380
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13446 Issued in CT
Practice address
6 Business Park Dr
Branford, CT 06405-2988
Phone
(203) 483-7979
NPI assigned
Feb 4, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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 13446 CT Primary

Addresses

Primary practice location

6 Business Park Dr
Branford, CT 06405-2988

Mailing address

47 N Main St
West Hartford, CT 06107-1926
Phone (860) 409-4595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13446CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anb-Ptsma Holdings, Inc. Physical Therapist CurrentSince Feb 3, 2022 Accepting new patients
The Physical Therapy Institute Past Accepting new patients
The Physical Therapy Institute Physical Therapist Past Accepting new patients
Sacred Heart University, Inc Physical Therapist PastSince Feb 6, 2022 Accepting new patients

Locations

1224 Main St
Ste 5
Branford, CT 06405
Phone (203) 483-7979

6 Business Park Dr
Ste 201
Branford, CT 06405
Phone (203) 483-7979

103 E Main St
Unit C
Plainville, CT 06062
Phone (860) 517-8885

47 N Main St
West Hartford, CT 06107
Phone (860) 409-4595

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": "1643932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1801540380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 N MAIN ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071926",
            "telephone_number": "860-409-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 BUSINESS PARK DR",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064052988",
            "telephone_number": "203-483-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHEL",
        "first_name": "COLIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-04",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "13446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.