Active NPI
Kristin Lauer Pronovost, PT
- Physical Therapist
- Naugatuck, CT
National Provider Identifier
1982728481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4351
- Practice address
- 4 Hazel Ave
Naugatuck, CT 06770-4706 - Phone
- (203) 723-1722
- NPI assigned
- Mar 19, 2007
- 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 Therapist | 225100000X | 4351 | CT | Primary |
Addresses
Primary practice location
4 Hazel Ave
Naugatuck, CT 06770-4706
Mailing address
11 Owl Ridge Rd
Woodbury, CT 06798-2539
Phone (203) 263-7041
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4351 | CT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982728481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 OWL RIDGE RD",
"city": "WOODBURY",
"state": "CT",
"postal_code": "067982539",
"telephone_number": "203-263-7041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 HAZEL AVE",
"city": "NAUGATUCK",
"state": "CT",
"postal_code": "067704706",
"telephone_number": "203-723-1722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRONOVOST",
"first_name": "KRISTIN",
"middle_name": "LAUER",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "4351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naugatuck, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.