Individual provider Active NPI

Kristen M Scallon, PT

  • Physical Therapist
  • Brookfield, CT
National Provider Identifier
1972557528
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
006365 Issued in CT
Practice address
31 Old Route 7
Brookfield, CT 06804-1711
Phone
(203) 740-0020
Fax
(203) 740-7354
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 006365 CT Primary

Addresses

Primary practice location

31 Old Route 7
Brookfield, CT 06804-1711

Mailing address

226 White St
Danbury, CT 06810-6814
Phone (203) 743-8817

Other identifiers 2

IdentifierTypeStateIssuer
650000531OtherCTMEDIDCARE PTAN
004210118MedicaidCT

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

LicenseStateTypeSpecialty
006365CTMDPhysical Therapist
6365CTMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1972557528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 WHITE ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106814",
            "telephone_number": "203-743-8817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 OLD ROUTE 7",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068041711",
            "telephone_number": "203-740-0020",
            "fax_number": "203-740-7354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCALLON",
        "first_name": "KRISTEN",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "006365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDIDCARE PTAN",
            "identifier": "650000531",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004210118",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.