Michelle E Mamos, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

21907 Issued in MA

Practice address

607 North Ave
Wakefield, MA 01880-1322

Phone

(781) 587-0776

NPI assigned

Sep 14, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shea Sports Chiropractic, LLC

  • Sports Physician Chiropractor
  • North Andover, MA
  • NPI 1104164102
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1235507872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 VERONA ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019042041",
            "telephone_number": "781-913-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 NORTH AVE",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018801322",
            "telephone_number": "781-587-0776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1820 Turnpike St",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "North Andover",
            "state": "MA",
            "postal_code": "018456398",
            "country_code": "US",
            "telephone_number": "978-688-6181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAMOS",
        "first_name": "MICHELLE",
        "middle_name": "E",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-14",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MA",
            "license": "21907",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "21907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna M Macdonald
• Brian Mackenna-Rice, LMHC, LADC I
• Danielle Maguire, LPTA
• Maurice Joseph Maher Cheffro, LICSW
• Erin Elizabeth Maiolino, OTA, COTA
• Tisa Manandhar
• Srija Mangavalli
• Catherine C. Mangie, LICSW
• Amy Mann, DMD
• Bernice Manning, LICSW

• Physical Therapist in Wakefield, MA
• Providers in Wakefield, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.