Active NPI
Kimberley Fletcher
- Physical Therapist
- Marlborough, MA
National Provider Identifier
1215380571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9402
- Practice address
- 2 Mount Royal Ave Ste 350
Marlborough, MA 01752-1976 - Phone
- (508) 853-4100
- NPI assigned
- Jul 21, 2016
- Last updated
- Nov 28, 2021
- 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 | 9402 | MA | Primary |
Addresses
Primary practice location
2 Mount Royal Ave Ste 350
Marlborough, MA 01752-1976
Mailing address
2 Mount Royal Ave Ste 350
Marlborough, MA 01752-1976
Phone (508) 853-4100
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9402 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638057600000",
"number": "1215380571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 MOUNT ROYAL AVE STE 350",
"city": "MARLBOROUGH",
"state": "MA",
"postal_code": "017521976",
"telephone_number": "508-853-4100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 MOUNT ROYAL AVE STE 350",
"city": "MARLBOROUGH",
"state": "MA",
"postal_code": "017521976",
"telephone_number": "508-853-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLETCHER",
"first_name": "KIMBERLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-21",
"last_updated": "2021-11-28",
"certification_date": "2021-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "9402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marlborough, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.