Individual provider Active NPI

Connor Steven Lingo, PHYSICAL THERAPIST

  • Physical Therapist
  • Wilmington, DE
National Provider Identifier
1992337786
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J1-0004183 Issued in DE
Practice address
4345 Kirkwood Hwy Ste 201
Wilmington, DE 19808-5131
Phone
(302) 635-9009
Fax
(302) 449-2047
NPI assigned
Feb 10, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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 J1-0004183 DE Primary

Addresses

Primary practice location

4345 Kirkwood Hwy Ste 201
Wilmington, DE 19808-5131

Mailing address

4345 Kirkwood Hwy Ste 201
Wilmington, DE 19808-5131
Phone (302) 635-9009

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200304002567 DE Practitioner - Physical Therapist in Private Practice 0749617645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4345 Kirkwood Hwy
Suite 201
Wilmington, DE 19808-5131
Phone (302) 635-9009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
J1-0004183DEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Physical Therapy and Sports Performance Limited Partnership CurrentSince Feb 7, 2020 Accepting new patients
Premier Physical Therapy and Sports Performance Limited Partnership Physical Therapist CurrentSince Feb 7, 2020 Accepting new patients

Locations

1050 Industrial Dr
Ste 210
Middletown, DE 19709

100 S Main St
Ste 300
Smyrna, DE 19977
Phone (302) 389-7855

4345 Kirkwood Hwy
Ste 201
Wilmington, DE 19808
Phone (302) 389-7855

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1992337786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4345 KIRKWOOD HWY STE 201",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198085131",
            "telephone_number": "302-635-9009",
            "fax_number": "302-449-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4345 KIRKWOOD HWY STE 201",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198085131",
            "telephone_number": "302-635-9009",
            "fax_number": "302-449-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINGO",
        "first_name": "CONNOR",
        "middle_name": "STEVEN",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0004183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.