Individual provider Active NPI

Kirstin Lane, PT

  • Physical Therapist
  • Enfield, CT
National Provider Identifier
1871727750
Registry record updated May 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
008525 Issued in CT
Practice address
101 Phoenix Ave
Suite 2D
Enfield, CT 06082-4471
Phone
(860) 741-2541
Fax
(860) 745-5264
NPI assigned
May 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2009

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 008525 CT Primary

Addresses

Primary practice location

101 Phoenix Ave
Suite 2D
Enfield, CT 06082-4471

Mailing address

101 Phoenix Ave
Suite 2D
Enfield, CT 06082-4471
Phone (860) 741-2541

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240327002861 MA Practitioner - Physical Therapist in Private Practice 4587715081 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006525CTMDPhysical Therapist
008525CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
DG Physical Therapy PC Physical Therapist CurrentSince Dec 20, 2023 Accepting new patients
DG Physical Therapy, P.C. CurrentSince Dec 20, 2023 Accepting new patients
Grey Physical Therapy & Sports Medicine Center of Enfield, PC Physical Therapist PastSince Jul 30, 2015 Accepting new patients

Locations

4 Meeting House Rd
Ste 5
Chelmsford, MA 01824
Phone (978) 970-2460

1415 Main St
Palmer, MA 01069
Phone (413) 283-8303

Organizations & group practices 3

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": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241654400000",
    "number": "1871727750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PHOENIX AVE",
            "address_2": "SUITE 2D",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824471",
            "telephone_number": "860-741-2541",
            "fax_number": "860-745-5264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PHOENIX AVE",
            "address_2": "SUITE 2D",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824471",
            "telephone_number": "860-741-2541",
            "fax_number": "860-745-5264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "KIRSTIN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-07",
        "last_updated": "2009-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "008525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.