BLACK ROCK PHYSICAL THERAPY (NPI# 1063650901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063650901 |
| Entity Type | Organization |
| Organization Name | BLACK ROCK PHYSICAL THERAPY |
| Other Organization Name | TLCPT |
| Practice Address |
2889 Fairfield Ave Bridgeport CT 06605-3211 |
| Practice Telephone | 2033351987 |
| Practice Fax Number | 2035490725 |
| Mailing Telephone | 2033351987 |
| Mailing Fax Number | 2035490725 |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2018-05-03 |
| Authorized Official Name | MS. TARA LYNN COLLINS (PHYSICAL THERAPIST/OWNER) |
| Authorized Official Telephone | 2033451720 |
| Authorized Official Credential | P.T., IMT.C., CS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
004078 | CT | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | MEDICARE PTAN | D100000150 | 01 |
| Other Name | Type Code |
|---|---|
| TLCPT | Former Legal Business Name - Organization |
| Street Address |
2889 FAIRFIELD AVE |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06605-3211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184696916 | Tara L. Collins | Physical Therapist | 2889 Fairfield Ave, Bridgeport, CT 06605-3211 | 2006-02-06 |
| 1730421397 | Eclectic Physical Therapy LLC | Clinic/Center | 2889 Fairfield Ave, Bridgeport, CT 06605-3211 | 2013-03-21 |
| 1134406382 | Justin Michael Shay I | Specialist | 2889 Fairfield Ave, Bridgeport, CT 06605-3211 | 2011-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497312276 | Stacy-ann Thompson-grant | Social Worker | 170 Bennet T Street, Bridgeport, CT 06605 | 2019-05-28 |
| 1720502149 | Sheree Amankwah | Counselor | 170 Bennett Street, Bridgeport, CT 06605 | 2017-07-27 |
| 1417477324 | Aracelis Robertson | Case Manager/Care Coordinator | 1646 Fairfield Avenue, 3rd Floor, Bridgeport, CT 06605 | 2017-06-21 |
| 1699158170 | Cortney Davis | Physician Assistant | 3250 Fairfield Ave, Unit 217, Bridgeport, CT 06605 | 2015-07-02 |
| 1083020051 | Douglas Mccoy | Nurse Practitioner | 46 Albion St., Bridgeport, CT 06605 | 2014-07-10 |
| 1932513785 | Hallie Claire Riggs | Social Worker | 1730 State St Ext, Bridgeport, CT 06605 | 2014-06-19 |
| 1831518513 | Yvonne Booy | Counselor | 46 Albion Street, Bridgeport, CT 06605 | 2014-04-10 |
| 1760556955 | Joel W Allen | Obstetrics & Gynecology | 625 Clinton Ave, Bridgeport, CT 06605 | 2006-11-20 |
| 1316046428 | Allen P Schlein | Orthopaedic Surgery | 650 Clinten Avenue, Bridgeport, CT 06605 | 2006-09-22 |
| 1336127984 | Hancock Pharmacy | Pharmacy | 1557 Fairfield Ave, Bridgeport, CT 06605 | 2006-01-04 |
| Find all providers in zip 06605 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437643061 | Mountain River Physical Therapy, LLC | Clinic/Center | 315 S Virginia Ave, Bridgeport, WV 26330-1744 | 2018-06-18 |
| 1275072985 | Bridgeport Hospital | Clinic/Center | 226 Mill Hill Ave, Bridgeport, CT 06610-2826 | 2017-02-14 |
| 1225446669 | Foundation Therapy LLC | Clinic/Center | 707 Woodrow Wilson Ray Cir, Bridgeport, TX 76426-5023 | 2014-07-29 |
| 1609014893 | Core Physical Therapy & Sports Medicine PC | Clinic/Center | 3180 Main St, Ste 303, 304, Bridgeport, CT 06606-4237 | 2009-01-27 |
| 1669413845 | Connecticut Physical Therapy | Clinic/Center | 4675 Main St, Bridgeport, CT 06606-1813 | 2006-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669070827 | Hometown Health, LLC | Clinic/Center | 54 Hazard Ave # 161, Enfield, CT 06082-3845 | 2020-10-10 |
| 1811502867 | Zion Pt Ct PC | Clinic/Center | 1555 Post Road East, Inside Sherpa, Westport, CT 06880 | 2020-09-15 |
| 1053920439 | Oss Sports Physical Therapy | Clinic/Center | 500 Newfield Ave Ste 11, Stamford, CT 06905-3745 | 2020-07-30 |
| 1558983403 | Centrality Physical Therapy & Wellness, PC | Clinic/Center | 705 Boston Post Rd Ste 1b, Guilford, CT 06437-2733 | 2020-05-14 |
| 1639703622 | Dr Yoon Physical Therapy Inc | Clinic/Center | 609 Farmington Ave Ste Ll2, Hartford, CT 06105-3081 | 2020-02-27 |
| 1558908897 | Duncaster, Inc. | Clinic/Center | 30 Loeffler Rd., Bloomfield, CT 06002 | 2019-12-05 |
| 1609413491 | Beyond Physical Therapy LLC | Clinic/Center | 120 Steele Rd, Bristol, CT 06010-5672 | 2019-11-29 |
| 1588214381 | Good Physio Clinic Inc | Clinic/Center | 701 Cottage Grove Rd Ste 110, Bloomfield, CT 06002-3080 | 2019-09-13 |
| 1972169241 | Align Health LLC | Clinic/Center | 133 Columbia Blvd, Waterbury, CT 06710-1706 | 2019-05-13 |
| 1396209029 | My Pain Guy LLC | Clinic/Center | 50 Quality St Unit 110615, Trumbull, CT 06611-7725 | 2019-01-28 |
| Find all providers with the same taxonomy | ||||
| City | BRIDGEPORT |
| Zip Code | 06605 |
Please comment or provide details below to improve the information on BLACK ROCK PHYSICAL THERAPY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.