Active NPI
Brynn Speroni
- Occupational Therapist
- Waltham, MA
National Provider Identifier
1003486283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 11163
- Practice address
- 303 Wyman St Ste 300
Waltham, MA 02451-1255 - Phone
- (877) 407-3422
- NPI assigned
- Jun 29, 2021
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 11163 | MA | Primary |
Addresses
Primary practice location
303 Wyman St Ste 300
Waltham, MA 02451-1255
Mailing address
7 Carnegie PLZ
Cherry Hill, NJ 08003-1000
Phone (877) 407-3422
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11163 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624924800000",
"number": "1003486283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 CARNEGIE PLZ",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "080031000",
"telephone_number": "877-407-3422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 WYMAN ST STE 300",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024511255",
"telephone_number": "877-407-3422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPERONI",
"first_name": "BRYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-29",
"last_updated": "2021-06-29",
"certification_date": "2021-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "11163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.