Organization Active NPI

Northampton Physical Therapy Clinic, Inc.

  • Physical Therapist
  • Northampton, MA
National Provider Identifier
1275622383
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
NORTHAMPTON PHYSICAL THERAPY CLINIC, INC.
Practice address
17 New South St - Sullivan SQ
Northampton, MA 01060
Phone
(413) 582-0005
Fax
(413) 582-7979
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Authorized official

Name
Ms. Linda Beaulieu, PTNPI 1053400051
Title
President
Phone
(413) 582-0005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

17 New South St - Sullivan SQ
Northampton, MA 01060

Mailing address

17 New South St - Sullivan SQ
Northampton, MA 01060
Phone (413) 582-0005

Other identifiers 1

IdentifierTypeStateIssuer
Y65679OtherMABC/BS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051103000025 MA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1254359839 Receives reassigned benefits from 1 practitioner
Practice locations: Northampton, MA

National Provider Directory

National Provider Directory

Locations

17 New South St
Northampton, MA 01060
Phone (413) 582-0005

17 New South St
Ste 102
Northampton, MA 01060
Phone (413) 582-0005

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1275622383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 NEW SOUTH ST - SULLIVAN SQ",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "01060",
            "telephone_number": "413-582-0005",
            "fax_number": "413-582-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 NEW SOUTH ST - SULLIVAN SQ",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "01060",
            "telephone_number": "413-582-0005",
            "fax_number": "413-582-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHAMPTON PHYSICAL THERAPY CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "BEAULIEU",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "413-582-0005",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "Y65679",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northampton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; 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.