Active NPI
Jacqueline Fasulo Pierce, PT
- Cardiopulmonary Physical Therapist
- Providence, RI
National Provider Identifier
1295885283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiopulmonary Physical Therapist
- License
- 00754
- Practice address
- 208 Collyer St
Pulmonary Rehab
Providence, RI 02904-1560 - Phone
- (401) 793-4080
- Fax
- (401) 793-4110
- NPI assigned
- Jan 11, 2007
- 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 |
|---|---|---|---|---|
| Cardiopulmonary Physical Therapist | 2251C2600X | 00754 | RI | Primary |
Addresses
Primary practice location
208 Collyer St
Pulmonary Rehab
Providence, RI 02904-1560
Mailing address
171 Broad St
North Attleboro, MA 02760-1103
Phone (508) 643-4603
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 |
|---|---|---|---|
| 00754 | RI | MD | Cardiopulmonary Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295885283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "171 BROAD ST",
"city": "NORTH ATTLEBORO",
"state": "MA",
"postal_code": "027601103",
"telephone_number": "508-643-4603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 COLLYER ST",
"address_2": "PULMONARY REHAB",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029041560",
"telephone_number": "401-793-4080",
"fax_number": "401-793-4110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIERCE",
"first_name": "JACQUELINE",
"middle_name": "FASULO",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251C2600X",
"taxonomy_group": "",
"desc": "Physical Therapist, Cardiopulmonary",
"state": "RI",
"license": "00754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.