Individual provider Active NPI

Amber Joyce Dagata, LMT

  • Mechanotherapist
  • Wilmington, MA
National Provider Identifier
1033441191
Registry record updated Jan 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
1805 Issued in MA
Practice address
12 Bay St
Suite 210
Wilmington, MA 01887-4122
Phone
(781) 315-1784
NPI assigned
Jan 31, 2010
Last updated
Jan 31, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mechanotherapist 172M00000X 1805 MA Primary

Addresses

Primary practice location

12 Bay St
Suite 210
Wilmington, MA 01887-4122

Mailing address

12 Bay St
Suite 210
Wilmington, MA 01887-4122
Phone (781) 315-1784

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

LicenseStateTypeSpecialty
1805MAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1264896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264896000000",
    "number": "1033441191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BAY ST",
            "address_2": "SUITE 210",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018874122",
            "telephone_number": "781-315-1784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 BAY ST",
            "address_2": "SUITE 210",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018874122",
            "telephone_number": "781-315-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGATA",
        "first_name": "AMBER",
        "middle_name": "JOYCE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-31",
        "last_updated": "2010-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "MA",
            "license": "1805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2010; 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.