Individual provider Active NPI

Beth Tannatt, DPT

  • Specialist
  • Mystic, CT
National Provider Identifier
1811960750
Registry record updated Jun 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
01975 Issued in RI
Practice address
2440 Gold Star Hwy
Mystic, CT 06355-1180
Phone
(860) 536-1001
Fax
(860) 536-1527
NPI assigned
Feb 10, 2006
Last updated
Jun 3, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 01975 RI Primary

Addresses

Primary practice location

2440 Gold Star Hwy
Mystic, CT 06355-1180

Mailing address

82 Stillman Avenue
Pawcatuck, CT 06379-1827
Phone (860) 536-1001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100728000004 CT Practitioner - Physical Therapist in Private Practice 3072539808

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

627 Norwich Salem Tpke
Unit 2
Oakdale, CT 06370-1066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01975RIMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Norwich Medical Associates, LLC CurrentSince Aug 31, 2023 Accepting new patients
Elite Physical Therapy, LLC Past Accepting new patients
Napatree Physical Therapy Inc Past Accepting new patients
Napatree Physical Therapy Inc PastSince Feb 5, 2012 Accepting new patients

Locations

12 Case St
Ste 103
Norwich, CT 06360
Phone (860) 222-0949

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275523200000",
    "number": "1811960750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 STILLMAN AVENUE",
            "city": "PAWCATUCK",
            "state": "CT",
            "postal_code": "063791827",
            "telephone_number": "860-536-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 GOLD STAR HWY",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063551180",
            "telephone_number": "860-536-1001",
            "fax_number": "860-536-1527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNATT",
        "first_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "RI",
            "license": "01975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mystic, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; 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.