Individual provider Active NPI

Laura Jean Reynolds, M.S.,P.T.

  • Physical Therapist
  • Essex, CT
National Provider Identifier
1861528622
Registry record updated Mar 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3779 Issued in CT
Practice address
180 Westbrook Rd
Unit 3
Essex, CT 06426-1517
Phone
(860) 767-7587
Fax
(860) 767-7587
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2011

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 3779 CT Primary

Addresses

Primary practice location

180 Westbrook Rd
Unit 3
Essex, CT 06426-1517

Mailing address

PO Box 919
Clinton, CT 06413-0919
Phone (860) 669-5438

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3779CTMDPhysical Therapist
003779CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Center of Madison Physical Therapist PastSince Dec 31, 1996 Accepting new patients
Cross Therapy, LLC Physical Therapist Past Accepting new patients
Physical Therapy Services of Guilford LLC Physical Therapist PastSince Aug 19, 1999 Accepting new patients
Integrative Physical Therapy, LLC Physical Therapist PastSince Apr 1, 2007 Accepting new patients

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299196800000",
    "number": "1861528622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919",
            "city": "CLINTON",
            "state": "CT",
            "postal_code": "064130919",
            "telephone_number": "860-669-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 WESTBROOK RD",
            "address_2": "UNIT 3",
            "city": "ESSEX",
            "state": "CT",
            "postal_code": "064261517",
            "telephone_number": "860-767-7587",
            "fax_number": "860-767-7587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "LAURA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "M.S.,P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2011-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "3779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Essex, CT

Sources for this page

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

Verify at the official NPI Registry.