Boston Mantra LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

BOSTON MANTRA LLC

Practice address

9A Broadway St
Lawrence, MA 01840

Phone

(617) 543-6366

NPI assigned

Feb 10, 2021

Last updated

Feb 10, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jonjy A Ananth, MD MBA

Title

Principal

Phone

(617) 543-6366

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612915200000",
    "number": "1093307951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 LAMPLIGHTER DRIVE",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "01545",
            "telephone_number": "617-543-6366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9A BROADWAY ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "01840",
            "telephone_number": "617-543-6366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON MANTRA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-10",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A",
        "authorized_official_last_name": "ANANTH",
        "authorized_official_first_name": "JONJY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "617-543-6366",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD MBA"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Lawrence, MA
• Providers in Lawrence, MA by specialty
• Speech-Language Pathologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.