Active NPI
Colleen Marie Richard, PTA
- Physical Therapy Assistant
- Leominster, MA
National Provider Identifier
1124258165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 8233
- Practice address
- 55 Cinema Blvd
Leominster, MA 01453-3290 - Phone
- (978) 401-3100
- NPI assigned
- Jul 24, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 8233 | MA | Primary |
Addresses
Primary practice location
55 Cinema Blvd
Leominster, MA 01453-3290
Mailing address
168 Hastings Rd
Ashburnham, MA 01430-1125
Phone (978) 821-4809
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8233 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248393600000",
"number": "1124258165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "168 HASTINGS RD",
"city": "ASHBURNHAM",
"state": "MA",
"postal_code": "014301125",
"telephone_number": "978-821-4809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 CINEMA BLVD",
"city": "LEOMINSTER",
"state": "MA",
"postal_code": "014533290",
"telephone_number": "978-401-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARD",
"first_name": "COLLEEN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-24",
"last_updated": "2009-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MA",
"license": "8233",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leominster, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.