Active NPI
Emily Kristin Connelly
- Physical Therapist
- North Andover, MA
National Provider Identifier
1215479894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT012517
- Practice address
- 220 Sutton St
North Andover, MA 01845-1680 - Phone
- (978) 682-7009
- NPI assigned
- Nov 14, 2016
- 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 | PT012517 | GA | Primary |
Addresses
Primary practice location
220 Sutton St
North Andover, MA 01845-1680
Mailing address
220 Sutton St
North Andover, MA 01845-1680
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 |
|---|---|---|---|
| PT012517 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479081600000",
"number": "1215479894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 SUTTON ST",
"city": "NORTH ANDOVER",
"state": "MA",
"postal_code": "018451680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 SUTTON ST",
"city": "NORTH ANDOVER",
"state": "MA",
"postal_code": "018451680",
"telephone_number": "978-682-7009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNELLY",
"first_name": "EMILY",
"middle_name": "KRISTIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-14",
"last_updated": "2016-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT012517",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Andover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.