Redwood Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

004755 Issued in CT

Legal business name

REDWOOD PHYSICAL THERAPY LLC

Practice address

60 Trigo Dr
Unit C
Middletown, CT 06457-6157

Phone

(860) 759-4175

NPI assigned

Feb 12, 2017

Last updated

Feb 12, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Stephen Chabak, PTNPI 1780626861

Title

Owner

Phone

(860) 759-4175

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen Todd Chabak, P.T.

  • Physical Therapist
  • Middletown, CT
  • NPI 1780626861
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1486857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486857600000",
    "number": "1912446840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HUBER MNR",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573719",
            "telephone_number": "860-759-4175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 TRIGO DR",
            "address_2": "UNIT C",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064576157",
            "telephone_number": "860-759-4175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDWOOD PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-12",
        "last_updated": "2017-02-12",
        "status": "A",
        "authorized_official_last_name": "CHABAK",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-759-4175",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CT",
            "license": "004755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mari Rebane-Mazzotta, MD
• Laura F. Reddington, PA-C
• Bhagyalakshmi Reddy, M.D.
• Kalpana Ginugu Reddy, MD
• Stephen Redmon, DC
• Ryan Reed
• Rebecca Shea Reilly, LCSW
• Steven Reiner, DDS
• Amy Reiniger
• Z Christopher Religa, DMD MS

• Physical Therapy Clinic/Center in Middletown, CT
• Providers in Middletown, CT by specialty
• Physical Therapy Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2017; 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.