Active NPI
Colleen Kelley
- Physical Therapy Assistant
- New London, CT
National Provider Identifier
1932737301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 719
- Practice address
- 31 Vauxhall St
New London, CT 06320-5723 - Phone
- (860) 442-4363
- NPI assigned
- Mar 31, 2020
- Last updated
- Mar 31, 2020
- 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 Therapy Assistant | 225200000X | 719 | CT | Primary |
Addresses
Primary practice location
31 Vauxhall St
New London, CT 06320-5723
Mailing address
31 Vauxhall St
New London, CT 06320-5723
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 719 | Other | CT | PTA LICENSE NUMBER |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585612800000",
"number": "1932737301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 VAUXHALL ST",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063205723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31 VAUXHALL ST",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063205723",
"telephone_number": "860-442-4363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "COLLEEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-31",
"last_updated": "2020-03-31",
"certification_date": "2020-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CT",
"license": "719",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTA LICENSE NUMBER",
"identifier": "719",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in New London, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.