Active NPI
Kerry Samuelson, PT
- Physical Therapist
- Boston, MA
National Provider Identifier
1215101142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 18204
- Practice address
- 75 Francis St
BWH, Rehab Services Tower 2C
Boston, MA 02115-6110 - Phone
- (617) 732-6853
- NPI assigned
- Apr 22, 2008
- 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 Therapist | 225100000X | 18204 | MA | Primary |
Addresses
Primary practice location
75 Francis St
BWH, Rehab Services Tower 2C
Boston, MA 02115-6110
Mailing address
17 Diane Dr
Medway, MA 02053-2358
Phone (508) 212-7729
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 |
|---|---|---|---|
| 18204 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208822400000",
"number": "1215101142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 DIANE DR",
"city": "MEDWAY",
"state": "MA",
"postal_code": "020532358",
"telephone_number": "508-212-7729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 FRANCIS ST",
"address_2": "BWH, REHAB SERVICES TOWER 2C",
"city": "BOSTON",
"state": "MA",
"postal_code": "021156110",
"telephone_number": "617-732-6853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUELSON",
"first_name": "KERRY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-22",
"last_updated": "2008-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "18204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.