NPIMap

Organization Active NPI

Everett Community Physical Therapy Inc.

  • Physical Therapist
  • Everett, MA
National Provider Identifier
1053786343
Registry record updated Dec 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
EVERETT COMMUNITY PHYSICAL THERAPY INC.
Practice address
563 Broadway Ste 2
Everett, MA 02149-3749
Phone
(617) 294-2385
NPI assigned
Dec 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2015

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

Authorized official

Name
Marie Mondesir
Title
President/General Manager
Phone
(774) 434-2006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

563 Broadway Ste 2
Everett, MA 02149-3749

Mailing address

563 Broadway Ste 2
Everett, MA 02149-3749
Phone (617) 294-2385

National Provider Directory

National Provider Directory

Locations

563 Broadway
Ste 2
Everett, MA 02149
Phone (617) 294-2385

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1449792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449792000000",
    "number": "1053786343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "563 BROADWAY STE 2",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021493749",
            "telephone_number": "617-294-2385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "563 BROADWAY STE 2",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021493749",
            "telephone_number": "617-294-2385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERETT COMMUNITY PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-11",
        "last_updated": "2015-12-11",
        "status": "A",
        "authorized_official_last_name": "MONDESIR",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT/GENERAL MANAGER",
        "authorized_official_telephone_number": "774-434-2006"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; 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.