Individual provider Active NPI

Dana Solomon, OTR

  • Early Intervention Provider Agency
  • Lynn, MA
National Provider Identifier
1003291022
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
1922174226 Issued in MA
Practice address
103 Johnson St
Lynn, MA 01902-4001
Phone
(781) 593-2727
Fax
(781) 593-2542
NPI assigned
Jul 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 1922174226 MA Primary

Addresses

Primary practice location

103 Johnson St
Lynn, MA 01902-4001

Mailing address

103 Johnson St
Lynn, MA 01902-4001
Phone (781) 593-2727

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210309002583 MA Practitioner - Occupational Therapist in Private Practice 8325454788 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11494MAMDMental Health Counselor
1922174226MAMDDevelopmental Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Wellness & Yoga Current Accepting new patients
Joint Ventures Physical Therapy, Inc. CurrentSince Feb 11, 2021 Accepting new patients
Joint Ventures Physical Therapy, Inc. CurrentSince Feb 11, 2021 Accepting new patients

Locations

10 Liberty Sq
Bsmt 1
Boston, MA 02109

648 Beacon St
Boston, MA 02215
Phone (617) 353-9345

204 Worcester St
#200
Wellesley, MA 02481

Organizations & group practices 3

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": "1437436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1003291022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 JOHNSON ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019024001",
            "telephone_number": "781-593-2727",
            "fax_number": "781-593-2542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 JOHNSON ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019024001",
            "telephone_number": "781-593-2727",
            "fax_number": "781-593-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "DANA",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-21",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "MA",
            "license": "1922174226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.