Colleen Kennedy Chapman, DPT
Individual provider Active NPI Physical Therapist · Holden, MA
NPI 1083014278 · NPPES record last updated Aug 2, 2023
Key facts
- NPI
- 1083014278
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 26943 (MA)
- Practice address
- 456 Main St Ste a-B
Holden, MA 01520-3708 - Phone
- (508) 721-0000
- Fax
- (508) 721-0100
- NPI assigned
- Aug 26, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230816002863 | MA | Practitioner - Physical Therapist in Private Practice | 2466770615 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26943 | MA | MD | Physical Therapist |
| 037831 | NY | MD | Physical Therapist |
| 63783 | OR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physical Therapy Innovations, Inc | Physical Therapist | Current |
Accepting new patients |
| Francis P. Defalco, PC | Past |
Accepting new patients |
Locations
489 Washington St
Ste 200
Auburn, MA 01501
Phone 5087210000199
456 Main St
Ste Ab
Holden, MA 01520
Phone (774) 696-8309
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 63783 | OR | |
| Physical Therapist | 225100000X | 037831 | NY | |
| Physical Therapist | 225100000X | 26943 | MA | Yes |
Addresses
Primary practice location
456 Main St Ste a-B
Holden, MA 01520-3708
Mailing address
489 Washington St Ste 200
Auburn, MA 01501-5709
Phone (508) 721-0000
Other practice location 1
489 Washington St Ste 200
Auburn, MA 01501-5709
Phone (508) 721-0000
Other names
- Colleen Elizabeth Kennedy
Other providers in Holden, MA
- Daniel Cassel
- Frenk Caushi
- Central Mass Counseling and Wellness
- Daniel Chapelle
- Robin L Chapman Rigney
- Christina Shaw DMD PLLC
- Lea Fontaine Christo
- Lee Ann Cipro
- Amy Cirillo
- Deborah Pearl Claflin Williams
All providers in Holden, MA · Physical Therapist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.