Active NPI
Kelley Springer Braun, RPT
- Physical Therapist
- Marblehead, MA
National Provider Identifier
1265767883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6170
- Practice address
- 1 Widger Rd
Marblehead, MA 01945-2146 - Phone
- (781) 631-8250
- NPI assigned
- Oct 15, 2009
- 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 | 6170 | MA | Primary |
Addresses
Primary practice location
1 Widger Rd
Marblehead, MA 01945-2146
Mailing address
9 Weston Rd
Marblehead, MA 01945-3017
Phone (781) 990-3506
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 |
|---|---|---|---|
| 6170 | MA | MD | Health Service Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258329600000",
"number": "1265767883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 WESTON RD",
"city": "MARBLEHEAD",
"state": "MA",
"postal_code": "019453017",
"telephone_number": "781-990-3506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 WIDGER RD",
"city": "MARBLEHEAD",
"state": "MA",
"postal_code": "019452146",
"telephone_number": "781-631-8250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAUN",
"first_name": "KELLEY",
"middle_name": "SPRINGER",
"name_prefix": "Mrs.",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-15",
"last_updated": "2009-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "6170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marblehead, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.