Renee Adele Blaise, P.T.A.

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

006887 Issued in NY

Practice address

93 Richards Ave
Apt 110
Norwalk, CT 06854-1679

Phone

(631) 671-9183

NPI assigned

Oct 25, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Renee Adele Belcher Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287964800000",
    "number": "1992005912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 RICHARDS AVE",
            "address_2": "APT 110",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068541679",
            "telephone_number": "631-671-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 RICHARDS AVE",
            "address_2": "APT 110",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068541679",
            "telephone_number": "631-671-9183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAISE",
        "first_name": "RENEE",
        "middle_name": "ADELE",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-25",
        "last_updated": "2010-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CT",
            "license": "1123",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "006887",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MS",
            "license": "4636",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "BELCHER",
            "middle_name": "ADELE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapy Assistant in Norwalk, CT
• Providers in Norwalk, CT by specialty
• Physical Therapy Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; 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.