Active NPI
Susan Anne Legere, PT
- Physical Therapist
- Danvers, MA
National Provider Identifier
1174868236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3934
- Practice address
- 63 Locust St
Danvers, MA 01923-2240 - Phone
- (978) 777-0011
- NPI assigned
- Nov 30, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3934 | MA | Primary |
Addresses
Primary practice location
63 Locust St
Danvers, MA 01923-2240
Mailing address
3 Princeton St
Danvers, MA 01923-1717
Phone (978) 750-4243
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3934 | Other | MA | COMMONWEALTH OF MASSACHUSETTS |
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 |
|---|---|---|---|
| 3934 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354233600000",
"number": "1174868236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 PRINCETON ST",
"city": "DANVERS",
"state": "MA",
"postal_code": "019231717",
"telephone_number": "978-750-4243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "63 LOCUST ST",
"city": "DANVERS",
"state": "MA",
"postal_code": "019232240",
"telephone_number": "978-777-0011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEGERE",
"first_name": "SUSAN",
"middle_name": "ANNE",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-30",
"last_updated": "2012-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "3934",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMONWEALTH OF MASSACHUSETTS",
"identifier": "3934",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Danvers, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.