Organization Active NPI

Warwick Avenue Physical Therapy, Inc

  • Physical Therapist
  • Warwick, RI
National Provider Identifier
1972714566
Registry record updated Jun 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT01500 Issued in RI
Legal business name
WARWICK AVENUE PHYSICAL THERAPY, INC
Practice address
1030 Warwick Ave
Warwick, RI 02888-3655
Phone
(401) 941-0494
NPI assigned
May 24, 2007
Last updated
Jun 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2010

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

Authorized official

Name
Matthew SmithNPI 1659428274
Title
President
Phone
(401) 941-0494

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT01500 RI Primary

Addresses

Primary practice location

1030 Warwick Ave
Warwick, RI 02888-3655

Mailing address

1030 Warwick Ave
Warwick, RI 02888-3655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100611000482 RI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1355471798 Receives reassigned benefits from 3 practitioners
Practice locations: Warwick, RI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276041600000",
    "number": "1972714566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 WARWICK AVE",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028883655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 WARWICK AVE",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028883655",
            "telephone_number": "401-941-0494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARWICK AVENUE PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2010-06-09",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-941-0494"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT01500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; 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.