Active NPI
Lindsay Prendergast
- Physical Therapist
- Bristol, CT
National Provider Identifier
1912115403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 007865
- Practice address
- 842 Clark Ave
Bristol, CT 06010-4065 - Phone
- (860) 582-9355
- NPI assigned
- May 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 007865 | CT | Primary |
Addresses
Primary practice location
842 Clark Ave
Bristol, CT 06010-4065
Mailing address
110 Haverhill Rd Ste 401
Amesbury, MA 01913-2121
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7865 | CT | MD | Dental Hygienist |
| 007865 | CT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262217600000",
"number": "1912115403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 HAVERHILL RD STE 401",
"city": "AMESBURY",
"state": "MA",
"postal_code": "019132121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "842 CLARK AVE",
"city": "BRISTOL",
"state": "CT",
"postal_code": "060104065",
"telephone_number": "860-582-9355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRENDERGAST",
"first_name": "LINDSAY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-18",
"last_updated": "2009-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "007865",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bristol, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.