Active NPI
Imago Rehab, Inc
- Neurorehabilitation Occupational Therapist
- Lowell, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurorehabilitation Occupational Therapist
- Legal business name
- IMAGO REHAB, INC
- Practice address
- 110 Canal St
3Rd Floor
Lowell, MA 01852 - Phone
- (617) 671-0789
- Fax
- (617) 250-8243
- NPI assigned
- Jul 9, 2021
- Last updated
- Apr 29, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kristin Nuckols, OTD, MOT, OTR/L
- Title
- Chief Clinical Officer
- Phone
- (617) 671-0789
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurorehabilitation Occupational Therapist | 225XN1300X | Primary |
Addresses
Primary practice location
110 Canal St
3Rd Floor
Lowell, MA 01852
Mailing address
110 Canal St Ste 3
Lowell, MA 01852-4589
Other names 1
- Imago Rehab, Inc.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, VA, TX, FL, NJ, IL, NH, TN, NC
Enrollment records 9
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Harvard University Health Services Pharmacy
- Clinic Pharmacy
- Cambridge, MA
- NPI 1023157351
Member Of
Locations
4215 Kelson Ave
Ste C
Marianna, FL 32446
Phone (617) 671-0789
416 Main St
Ste 601
Peoria, IL 61602
Phone (217) 341-6550
1167 Massachusetts Ave
Arlington, MA 02476
Phone (508) 686-1155
110 Canal St
Ste 3
Lowell, MA 01852
Phone (617) 671-0789
500 Unicorn Park Dr
Ste 300
Woburn, MA 01801
Phone (781) 214-1165
Practitioners & affiliated clinicians
Practitioners 25
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Physical Therapist
- Lowell, MA
- NPI 1568355352
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625788800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1777420800000",
"number": "1205407236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 CANAL ST STE 3",
"city": "LOWELL",
"state": "MA",
"postal_code": "018524589",
"fax_number": "617-250-8243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 CANAL ST",
"address_2": "3RD FLOOR",
"city": "LOWELL",
"state": "MA",
"postal_code": "01852",
"telephone_number": "617-671-0789",
"fax_number": "617-250-8243"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IMAGO REHAB, INC",
"organizational_subpart": "NO",
"enumeration_date": "2021-07-09",
"last_updated": "2026-04-29",
"certification_date": "2026-04-29",
"status": "A",
"authorized_official_last_name": "NUCKOLS",
"authorized_official_first_name": "KRISTIN",
"authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
"authorized_official_telephone_number": "617-671-0789",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "OTD, MOT, OTR/L"
},
"taxonomies": [
{
"code": "225XN1300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist, Neurorehabilitation",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Imago Rehab, Inc.",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "Imago Rehab, Inc.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Lowell, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.