NPIMap

Individual provider Active NPI

Corey R Mastin

  • Physical Therapist
  • Portsmouth, NH
National Provider Identifier
1124306980
Registry record updated Jul 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
NH3637 Issued in NH
Practice address
15 Rye St
Ste 125
Portsmouth, NH 03801-6829
Phone
(603) 610-2200
Fax
(603) 610-2202
NPI assigned
Jul 28, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NH3637 NH Primary

Addresses

Primary practice location

15 Rye St
Ste 125
Portsmouth, NH 03801-6829

Mailing address

15 Rye St
Ste 125
Portsmouth, NH 03801-6829
Phone (603) 610-2200

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Vna PastSince Aug 16, 2021 Accepting new patients
Abilities Rehabilitation Center, LLC Physical Therapist PastSince Nov 18, 2002 Accepting new patients
Merrimack Valley Physical Therapy Physical Therapist Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1311811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311811200000",
    "number": "1124306980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 RYE ST",
            "address_2": "STE 125",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038016829",
            "telephone_number": "603-610-2200",
            "fax_number": "603-610-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 RYE ST",
            "address_2": "STE 125",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038016829",
            "telephone_number": "603-610-2200",
            "fax_number": "603-610-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTIN",
        "first_name": "COREY",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-28",
        "last_updated": "2011-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "NH3637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2011; 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.