Individual provider Active NPI

Jamie L Missios, PT

  • Physical Therapist
  • South Dennis, MA
National Provider Identifier
1326289919
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
18588 Issued in MA
Practice address
485 Route 134
South Dennis, MA 02660-3431
Phone
(508) 394-0941
NPI assigned
Mar 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 22510000X MA
Physical Therapist 225100000X 18588 MA Primary

Addresses

Primary practice location

485 Route 134
South Dennis, MA 02660-3431

Mailing address

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325
Phone (888) 238-9408

Other identifiers 1

IdentifierTypeStateIssuer
225100000XMedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200518001528 MA Practitioner - Physical Therapist in Private Practice 4183055676 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22510000XMAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
DG Physical Therapy, P.C. CurrentSince Apr 14, 2020 Accepting new patients
DG Physical Therapy PC Physical Therapist CurrentSince Apr 14, 2020 Accepting new patients

Locations

4 Meeting House Rd
Ste 5
Chelmsford, MA 01824
Phone (978) 970-2460

4714 Gettysburg Rd
Mechanicsburg, PA 17055
Phone (888) 735-6332

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1326289919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "888-238-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 ROUTE 134",
            "city": "SOUTH DENNIS",
            "state": "MA",
            "postal_code": "026603431",
            "telephone_number": "508-394-0941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISSIOS",
        "first_name": "JAMIE",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-12",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MA",
            "license": "22510000X",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "18588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "225100000X",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Dennis, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; 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.