Active NPI
Jessica Bourque, PT
- Physical Therapist
- Medfield, MA
National Provider Identifier
1275936718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8777 PT
- Practice address
- 147 High St
Medfield, MA 02052-3116 - Phone
- (617) 640-7275
- NPI assigned
- Sep 29, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 8777 PT | MA | Primary |
Addresses
Primary practice location
147 High St
Medfield, MA 02052-3116
Mailing address
147 High St
Medfield, MA 02052-3116
Phone (617) 640-7275
Other names 1
- Jessica Steanrs
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 |
|---|---|---|---|
| 8777 PT | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411948800000",
"number": "1275936718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 HIGH ST",
"city": "MEDFIELD",
"state": "MA",
"postal_code": "020523116",
"telephone_number": "617-640-7275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "147 HIGH ST",
"city": "MEDFIELD",
"state": "MA",
"postal_code": "020523116",
"telephone_number": "617-640-7275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURQUE",
"first_name": "JESSICA",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-29",
"last_updated": "2014-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "8777 PT",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "STEANRS",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Medfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.