Active NPI
James M Theriault
- Occupational Therapy Assistant
- Somerset, MA
National Provider Identifier
1134630775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 3025
- Practice address
- 279 Vermont Ave
Somerset, MA 02726 - Phone
- (774) 888-8233
- NPI assigned
- Oct 23, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 3025 | MA | Primary |
Addresses
Primary practice location
279 Vermont Ave
Somerset, MA 02726
Mailing address
279 Vermont Ave
Somerset, MA 02726-3830
Phone (774) 888-8233
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3025 | Other | MA | ALLIED HEALTH PROFESSIONALS |
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 |
|---|---|---|---|
| 3025 | MA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508716800000",
"number": "1134630775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "279 VERMONT AVE",
"city": "SOMERSET",
"state": "MA",
"postal_code": "027263830",
"telephone_number": "774-888-8233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "279 VERMONT AVE",
"city": "SOMERSET",
"state": "MA",
"postal_code": "02726",
"telephone_number": "774-888-8233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THERIAULT",
"first_name": "JAMES",
"middle_name": "M",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-10-23",
"last_updated": "2017-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MA",
"license": "3025",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALLIED HEALTH PROFESSIONALS",
"identifier": "3025",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Somerset, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.