NPIMap

Organization Active NPI

Score, LLC

  • Physical Therapist
  • Middlebury, CT
National Provider Identifier
1891822607
Registry record updated Oct 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SCORE, LLC
Practice address
1579 Straits Tpke
Middlebury, CT 06762-1835
Phone
(203) 577-2002
Fax
(203) 577-2060
NPI assigned
Feb 28, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Michael Andrew Dane, PTNPI 1699772475
Title
Member
Phone
(203) 577-2002

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

Practitioners 21

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

View all 21

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20040712000567 CT Part B Supplier - Clinic/Group Practice 0749268175 Receives reassigned benefits from 7 practitioners
Practice locations: Middlebury, CT; Southbury, CT; Woodbury, CT
O20100930092289 CT DME Supplier - Independently-Practicing Physical Therapist 0749268175 Practice locations: Middlebury, CT

National Provider Directory

National Provider Directory

Locations

1579 Straits Tpke
Ofc Park
Middlebury, CT 06762
Phone (203) 598-0700

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1579 Straits Tpke
Middlebury, CT 06762-1835

Mailing address

1579 Straits Tpke
Middlebury, CT 06762-1835
Phone (203) 577-2002

Other practice location 1

51 Sherman Hill Rd Ste A201
Woodbury, CT 06798-3694
Phone (203) 263-3104

Other practice location 2

2 Pomperaug Office Park Ste 303
Southbury, CT 06488-2292
Phone (203) 264-1735

Other practice location 3

82 Providence St
Putnam, CT 06260-1530
Phone (860) 315-9123

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
4177318MedicaidCT
004177318MedicaidCT

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 29, 2018.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540771200000",
    "number": "1891822607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1579 STRAITS TPKE",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621835",
            "telephone_number": "203-577-2002",
            "fax_number": "203-577-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1579 STRAITS TPKE",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621835",
            "telephone_number": "203-577-2002",
            "fax_number": "203-577-2060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51 Sherman Hill Rd Ste A201",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "CT",
            "postal_code": "067983694",
            "country_code": "US",
            "telephone_number": "203-263-3104",
            "fax_number": "203-263-3104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Pomperaug Office Park Ste 303",
            "address_purpose": "LOCATION",
            "city": "Southbury",
            "state": "CT",
            "postal_code": "064882292",
            "country_code": "US",
            "telephone_number": "203-264-1735",
            "fax_number": "203-264-9251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "82 Providence St",
            "address_purpose": "LOCATION",
            "city": "Putnam",
            "state": "CT",
            "postal_code": "062601530",
            "country_code": "US",
            "telephone_number": "860-315-9123",
            "fax_number": "860-315-9088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SCORE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2018-10-29",
        "status": "A",
        "authorized_official_last_name": "DANE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "203-577-2002",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4177318",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004177318",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; 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.