Active NPI
Bethany Corvello, DPT
- Physical Therapist
- Dorchester Center, MA
National Provider Identifier
1306173547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 17394
- Practice address
- 540 Gallivan Blvd
Dorchester Center, MA 02124-5400 - Phone
- (617) 282-1200
- Fax
- (617) 282-9988
- NPI assigned
- Nov 9, 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 | 17394 | MA | Primary |
Addresses
Primary practice location
540 Gallivan Blvd
Dorchester Center, MA 02124-5400
Mailing address
110 Eisenhower Rd
Swansea, MA 02777-3104
Phone (857) 222-7894
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 |
|---|---|---|---|
| 17394 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597017600000",
"number": "1306173547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 EISENHOWER RD",
"city": "SWANSEA",
"state": "MA",
"postal_code": "027773104",
"telephone_number": "857-222-7894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 GALLIVAN BLVD",
"city": "DORCHESTER CENTER",
"state": "MA",
"postal_code": "021245400",
"telephone_number": "617-282-1200",
"fax_number": "617-282-9988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORVELLO",
"first_name": "BETHANY",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-09",
"last_updated": "2020-08-10",
"certification_date": "2020-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "17394",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dorchester Center, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.