CREEKSIDE PHYSICAL THERAPY PC (NPI# 1891989661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891989661 |
| Entity Type | Organization |
| Organization Name | CREEKSIDE PHYSICAL THERAPY PC |
| Practice Address |
14318 Route 62 Collins NY 14034-9788 |
| Practice Telephone | 7165328129 |
| Practice Fax Number | 7165329201 |
| Mailing Telephone | 7165328129 |
| Mailing Fax Number | 7165329201 |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2008-05-01 |
| Authorized Official Name | MRS. ELLEN BETH WILSON (PRESIDENT) |
| Authorized Official Telephone | 7165328129 |
| Authorized Official Credential | P.T. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
008212 | NY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | BLUE CROSS/BLUE SHIELD OF | 000623245003 | 01 |
| NY | UNIVERA | 00010244901 | 01 |
| NY | INDEPENDENT HEALTH | 9308583 | 01 |
| NY | EMPIRE | 822231 | 01 |
| Street Address |
14318 ROUTE 62 |
| City | COLLINS |
| State | NY |
| Zip Code | 14034-9788 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730149386 | Dawn M Thurnherr | Physical Therapist | 14318 Route 62, Collins, NY 14034-9788 | 2006-03-27 |
| 1992077309 | Nina Marie Hansen | Physical Therapist | 14318 Route 62, Collins, NY 14034-9788 | 2012-01-31 |
| 1487615522 | Ellen B Wilson | Physical Therapist | 14318 Route 62, Collins, NY 14034-9788 | 2006-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962708909 | Robert Carmelo Cininesi | Physical Therapist | 13804 Rte.62, Collins, NY 14034 | 2011-02-09 |
| 1811354582 | Allen Ward | Social Worker | 72 Middle Road, Collins, NY 14034 | 2016-01-26 |
| 1073972444 | Patricia Cooper | Case Manager/Care Coordinator | 72 Middle Rd., Collins, NY 14034-0389 | 2016-02-15 |
| 1659759470 | Buffalo Psychiatric Center | Psychiatric Hospital | 72 Middle Road, Collins, NY 14034-0389 | 2015-05-13 |
| 1053939462 | Alayna Kehr | Pharmacist | 13874 Sara Ln, Collins, NY 14034-9727 | 2020-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053939462 | Alayna Kehr | Pharmacist | 13874 Sara Ln, Collins, NY 14034-9727 | 2020-07-12 |
| 1568089977 | Kaitlin Johnson Hinton | Nurse Practitioner | 3275 Us 49 E, Collins, MS 39428 | 2020-07-01 |
| 1154945848 | Anna Fails | Nurse Practitioner | 3275 Highway 49 Ste E, Collins, MS 39428-3776 | 2020-05-29 |
| 1760011084 | Felicia Taylor | Licensed Practical Nurse | 1125 William Warren Rd, Collins, MS 39428-5692 | 2020-04-07 |
| 1366075236 | Pine Ridge Family Clinic, LLC | Nurse Practitioner | 3248 Highway 49, Collins, MS 39428 | 2020-02-19 |
| 1033754304 | Marie Lynn White | Counselor | 341 Jones Chapel Rd, Collins, MS 39428-5865 | 2019-11-11 |
| 1245874981 | Kim Michelle Stubbs | Nurse Practitioner | 77 Cmj Drive, Collins, MS 39428 | 2019-11-06 |
| 1558911800 | William Clyde Saulters | Technician | 749 Seminary Mike Conner Rd, Collins, MS 39428 | 2019-09-18 |
| 1467018119 | Jacqueline Crosby | Non-emergency Medical Transport (VAN) | 98 Hopewell School Rd, Collins, MS 39428-5759 | 2019-05-17 |
| 1679080568 | Catrina Deshan Lockhart | Registered Nurse | 472 Highway 35, Collins, MS 39428-6216 | 2018-01-02 |
| Find all providers in COLLINS | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528572732 | Enduracare Acute Care Services LLC | Clinic/Center | 710 Main St Ste 10, Collins, MS 39428-6293 | 2017-11-27 |
| 1225547227 | 2083 Therapy, LLC | Clinic/Center | 710 Main St Ste 10, Collins, MS 39428-6293 | 2017-09-22 |
| 1093875866 | Restore Physical Therapy Inc. | Clinic/Center | 10 Melody Ln, Collins, MS 39428-9002 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639842 | Lion Physical Therapy Pllc | Clinic/Center | 2420 Jackson Ave Ste 205, Long Island City, NY 11101-4332 | 2020-11-02 |
| 1144820762 | Phoenix Physical Therapy Pllc | Clinic/Center | 337 Blaisdell Rd, Orangeburg, NY 10962-2508 | 2020-11-01 |
| 1174122808 | The Body Workshop Physical Therapy Pllc | Clinic/Center | 70 Balsam Way, Clifton Park, NY 12065-6787 | 2020-10-23 |
| 1013516012 | Laura Alexandra Kelly | Clinic/Center | 599 Knollwood Rd, White Plains, NY 10603-1918 | 2020-10-21 |
| 1982202404 | Mobility Health Physical Therapy | Clinic/Center | 10545 Avenue M, Brooklyn, NY 11236-4603 | 2020-10-16 |
| 1053919589 | Hun K Physical Therapy P.C. | Clinic/Center | 4015 81st St Apt A65, Elmhurst, NY 11373-1343 | 2020-10-16 |
| 1730786369 | Palisades Lymphedema & Oncology Physiotherapy, Rllp | Clinic/Center | 7 New Lake Rd, Valley Cottage, NY 10989-1868 | 2020-10-06 |
| 1831796713 | Quality Movement Restoration, LLC | Clinic/Center | 12027 165th St, Jamaica, NY 11434-2526 | 2020-10-05 |
| 1134726359 | John Lathrop Physical Therapy Pllc | Clinic/Center | 3152 35th St Apt 1r, Astoria, NY 11106-1546 | 2020-10-01 |
| 1720695430 | John Bianchini Pt PC | Clinic/Center | 11 N Nancy Pl, Massapequa, NY 11758-1912 | 2020-09-26 |
| Find all providers with the same taxonomy | ||||
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| 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.