Active NPI
Mary Ellen Campbell, PTA
- Physical Therapy Assistant
- Peabody, MA
National Provider Identifier
1235193244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 557
- Practice address
- 2 Essex Center Dr
Peabody, MA 01960-2902 - Phone
- (978) 977-4115
- NPI assigned
- Apr 14, 2006
- 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 Therapy Assistant | 225200000X | 557 | MA | Primary |
Addresses
Primary practice location
2 Essex Center Dr
Peabody, MA 01960-2902
Mailing address
147 Milk St
Provider Enrollment 9TH Floor
Boston, MA 02109-4806
Phone (617) 559-8051
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B267 | Other | MA | HARVARD PILGRIM |
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 |
|---|---|---|---|
| 557 | MA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239062400000",
"number": "1235193244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 MILK ST",
"address_2": "PROVIDER ENROLLMENT 9TH FLOOR",
"city": "BOSTON",
"state": "MA",
"postal_code": "021094806",
"telephone_number": "617-559-8051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 ESSEX CENTER DR",
"city": "PEABODY",
"state": "MA",
"postal_code": "019602902",
"telephone_number": "978-977-4115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "MARY ELLEN",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-14",
"last_updated": "2009-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MA",
"license": "557",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "B267",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peabody, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.