Active NPI
Carol Mierzwa, PT
- Physical Therapist
- Winsted, CT
National Provider Identifier
1871733063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 004842
- Practice address
- 115 Spencer St
Winsted, CT 06098-1140 - Phone
- (860) 738-5810
- Fax
- (860) 738-5820
- NPI assigned
- Feb 27, 2009
- Last updated
- Nov 21, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 004842 | CT | Primary |
Addresses
Primary practice location
115 Spencer St
Winsted, CT 06098-1140
Mailing address
115 Spencer St
Winsted, CT 06098-1140
Phone (860) 738-5810
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 076572 | Other | CT | MEDICARE GROUP ID |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004842 | CT | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384992000000",
"number": "1871733063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 SPENCER ST",
"city": "WINSTED",
"state": "CT",
"postal_code": "060981140",
"telephone_number": "860-738-5810",
"fax_number": "860-738-5820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 SPENCER ST",
"city": "WINSTED",
"state": "CT",
"postal_code": "060981140",
"telephone_number": "860-738-5810",
"fax_number": "860-738-5820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIERZWA",
"first_name": "CAROL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-27",
"last_updated": "2013-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "004842",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP ID",
"identifier": "076572",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winsted, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.