Individual provider Active NPI

Jessica Christine Lariviere, DPT

  • Physical Therapist
  • Canton, MA
National Provider Identifier
1013323716
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20864 Issued in MA
Practice address
95 Washington St
Ste 462
Canton, MA 02021-4006
Phone
(781) 828-7920
Fax
(781) 828-7951
NPI assigned
Jul 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 20864 MA Primary

Addresses

Primary practice location

95 Washington St
Ste 462
Canton, MA 02021-4006

Mailing address

95 Washington St
Ste 462
Canton, MA 02021-4006
Phone (781) 828-7920

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190831000174 IL Practitioner - Physical Therapist in Private Practice 2769608520 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20864MAMDGeneral Practice Dentistry
7974SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Therapy Partners, LLC. Physical Therapist CurrentSince Jul 22, 2022 Accepting new patients
Cadence Physical Therapy Co Physical Therapist CurrentSince Mar 11, 2024 Accepting new patients

Locations

1300 Busch Pkwy
Buffalo Grove, IL 60089
Phone (847) 378-4970

Organizations & group practices 2

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": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1013323716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 WASHINGTON ST",
            "address_2": "STE 462",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020214006",
            "telephone_number": "781-828-7920",
            "fax_number": "781-828-7951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 WASHINGTON ST",
            "address_2": "STE 462",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020214006",
            "telephone_number": "781-828-7920",
            "fax_number": "781-828-7951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARIVIERE",
        "first_name": "JESSICA",
        "middle_name": "CHRISTINE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-02",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "20864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.