Active NPI
Marlo Lagrant
- Physical Therapist
- Amherst, MA
National Provider Identifier
1013067396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11460
- Practice address
- 150 Infirmary Way
Amherst, MA 01003-9288 - Phone
- (413) 577-5000
- Fax
- (413) 577-5117
- NPI assigned
- Jan 11, 2007
- 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 Therapist | 225100000X | 11460 | MA | Primary |
Addresses
Primary practice location
150 Infirmary Way
Amherst, MA 01003-9288
Mailing address
150 Infirmary Way
Amherst, MA 01003-9288
Phone (413) 577-5000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2870192 | Other | MA | AETNA |
| Y67488 | Other | MA | BLUE CROSS BLUE SHIELD MA |
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 |
|---|---|---|---|
| 11460 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013067396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 INFIRMARY WAY",
"city": "AMHERST",
"state": "MA",
"postal_code": "010039288",
"telephone_number": "413-577-5000",
"fax_number": "413-577-5117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 INFIRMARY WAY",
"city": "AMHERST",
"state": "MA",
"postal_code": "010039288",
"telephone_number": "413-577-5000",
"fax_number": "413-577-5117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAGRANT",
"first_name": "MARLO",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "11460",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2870192",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD MA",
"identifier": "Y67488",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Amherst, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.