Individual provider Active NPI

Jodi R Brown, PT, DPT, L-ATC

  • Physical Therapist
  • Gloucester, MA
National Provider Identifier
1265670947
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19871 Issued in MA
Practice address
7 Gloucester Crossing Rd
Gloucester, MA 01930
Phone
(978) 529-2525
NPI assigned
Feb 3, 2009
Last updated
Nov 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1788 MA
Physical Therapist 225100000X 19871 MA Primary

Addresses

Primary practice location

7 Gloucester Crossing Rd
Gloucester, MA 01930

Mailing address

7 Gloucester Crossing Rd
Gloucester, MA 01930
Phone (978) 529-2525

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Jodi.Brown@Lahey.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211227001372 MA Practitioner - Physical Therapist in Private Practice 4688065733 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1788MAMDNutritionist
19871MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Dec 1, 2021 Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8085

7 Gloucester Crossing Rd
Gloucester, MA 01930
Phone (978) 529-2525

Interoperability endpoints

  • Direct secure messaging: jodi.brown@lahey.org

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1233619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1265670947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 GLOUCESTER CROSSING RD",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "01930",
            "telephone_number": "978-529-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 GLOUCESTER CROSSING RD",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "01930",
            "telephone_number": "978-529-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JODI",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT, L-ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-03",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "1788",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "19871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jodi.Brown@Lahey.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7 Gloucester Crossing Rd",
            "city": "Gloucester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "01930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gloucester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.