Nicole Janine Dubou, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

22847 Issued in MA

Practice address

1102 Washington St
Braintree, MA 02184-5438

Phone

(781) 848-3100

NPI assigned

Dec 9, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1023655032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 WESTBOURNE ST",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021313324",
            "telephone_number": "502-415-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 WASHINGTON ST",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845438",
            "telephone_number": "781-848-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOU",
        "first_name": "NICOLE",
        "middle_name": "JANINE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-09",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "22847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Email",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1102 Washington St",
            "city": "Braintree",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021845438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapist in Braintree, MA
• Providers in Braintree, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.