Active NPI
Evan Kittredge
- Physical Therapist
- Peabody, MA
National Provider Identifier
1326216805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2708
- Practice address
- 15 Bradford Rd
Peabody, MA 01960-4501 - Phone
- (866) 953-0011
- NPI assigned
- Feb 18, 2008
- Sex
- Male
- 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 | 2708 | HI | Primary |
Addresses
Primary practice location
15 Bradford Rd
Peabody, MA 01960-4501
Mailing address
325 N St Paul St
Suite 4200
Dallas, TX 75301-0001
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 |
|---|---|---|---|
| 2708 | HI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203292800000",
"number": "1326216805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 N ST PAUL ST",
"address_2": "SUITE 4200",
"city": "DALLAS",
"state": "TX",
"postal_code": "753010001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 BRADFORD RD",
"city": "PEABODY",
"state": "MA",
"postal_code": "019604501",
"telephone_number": "866-953-0011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KITTREDGE",
"first_name": "EVAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-18",
"last_updated": "2008-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "HI",
"license": "2708",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peabody, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.