NPIMap

Organization Active NPI

Innovative Physical Therapy Solutions PC

  • Physical Medicine & Rehabilitation Physician
  • Watertown, NY
National Provider Identifier
1891741302
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
INNOVATIVE PHYSICAL THERAPY SOLUTIONS PC
Practice address
316 Sherman St
Watertown, NY 13601-3614
Phone
(315) 786-0655
Fax
(315) 786-7993
NPI assigned
May 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Authorized official

Name
Cheryl L Howard, PTNPI 1366499295
Title
President
Phone
(315) 786-0655

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

316 Sherman St
Watertown, NY 13601-3614

Mailing address

445 Factory St
PO Box 91
Watertown, NY 13601-2729
Phone (315) 782-4207

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050225000332 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5698728004 Receives reassigned benefits from 5 practitioners
Practice locations: Watertown, NY

National Provider Directory

National Provider Directory

Locations

316 Sherman St
Watertown, NY 13601
Phone (315) 786-0655

109 Court St
Watertown, NY 13601
Phone (315) 786-0655

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209513600000",
    "number": "1891741302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 FACTORY ST",
            "address_2": "PO BOX 91",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012729",
            "telephone_number": "315-782-4207",
            "fax_number": "215-782-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 SHERMAN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013614",
            "telephone_number": "315-786-0655",
            "fax_number": "315-786-7993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE PHYSICAL THERAPY SOLUTIONS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2008-04-30",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-786-0655",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; 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.