Active NPI
Carol Cole, PTA
- Physical Therapy Assistant
- Waterbury, CT
National Provider Identifier
1992415657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 101
- Practice address
- 64 Robbins St
Waterbury, CT 06708-2613 - Phone
- (203) 573-6041
- NPI assigned
- Dec 2, 2022
- 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 Therapy Assistant | 225200000X | 101 | CT | Primary |
Addresses
Primary practice location
64 Robbins St
Waterbury, CT 06708-2613
Mailing address
22 Tompkins St
Waterbury, CT 06708-1458
Phone (203) 419-0381
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004190328 | Medicaid | CT |
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 |
|---|---|---|---|
| 101 | CT | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669939200000",
"number": "1992415657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 TOMPKINS ST",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067081458",
"telephone_number": "203-419-0381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "64 ROBBINS ST",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067082613",
"telephone_number": "203-573-6041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLE",
"first_name": "CAROL",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-02",
"last_updated": "2022-12-02",
"certification_date": "2022-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CT",
"license": "101",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004190328",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.