Michelle Lena Peloquin, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1080 Issued in CT

Practice address

1 Emerson Dr
Windsor, CT 06095-3204

Phone

(860) 640-6339

NPI assigned

Oct 25, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1861745002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 MONROVIA ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011043113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EMERSON DR",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060953204",
            "telephone_number": "860-640-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELOQUIN",
        "first_name": "MICHELLE",
        "middle_name": "LENA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-25",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CT",
            "license": "1080",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keegan Pearson
• Shevane Pearson
• Trudy Tamara Pearson
• Kaela Peich
• Maris K Pelkey, BEHAVIOR ANALYST
• Christopher Ralph Penta, PSY.D.
• Melissa Peracchio, BCBA
• Nelson Perez, LADC
• Yeneiry G Perez
• Amanda Rae Perrin

• Physical Therapy Assistant in Windsor, CT
• Providers in Windsor, CT by specialty
• Physical Therapy Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.