Active NPI
Nicholas Evan Salis, DPT, ATC
- Physical Therapist
- Bridgeport, CT
National Provider Identifier
1851683270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 26 Wade Ter
Bridgeport, CT 06604-1806 - Phone
- (603) 438-1622
- NPI assigned
- May 3, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary | ||
| Athletic Trainer | 2255A2300X | 000643 | CT |
Addresses
Primary practice location
26 Wade Ter
Bridgeport, CT 06604-1806
Mailing address
26 Wade Ter
Bridgeport, CT 06604-1806
Phone (603) 438-1622
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
| License | State | Type | Specialty |
|---|---|---|---|
| 000643 | CT | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304380800000",
"number": "1851683270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 WADE TER",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066041806",
"telephone_number": "603-438-1622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 WADE TER",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066041806",
"telephone_number": "603-438-1622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALIS",
"first_name": "NICHOLAS",
"middle_name": "EVAN",
"name_prefix": "Mr.",
"credential": "DPT, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-03",
"last_updated": "2011-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CT",
"license": "000643",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.