Individual provider Active NPI

Carol Emmons

  • Physical Therapist
  • Dedham, MA
National Provider Identifier
1336968809
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL5471 Issued in MA
Practice address
391 Common St
Dedham, MA 02026-4055
Phone
(877) 407-3422
Fax
(877) 407-4329
NPI assigned
Oct 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL5471 MA Primary

Addresses

Primary practice location

391 Common St
Dedham, MA 02026-4055

Mailing address

7 Carnegie PLZ
Cherry Hill, NJ 08003-1000
Phone (877) 407-3422

Other names 1

  • Carol Gronberg Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241021001249 MA Practitioner - Physical Therapist in Private Practice 4486186012 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab Ma LLC Physical Therapist CurrentSince Sep 1, 2024 Accepting new patients

Locations

303 Wyman St
Ste 300
Waltham, MA 02451
Phone (781) 330-0577

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 1

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": "1728518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1336968809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CARNEGIE PLZ",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031000",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 COMMON ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020264055",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMMONS",
        "first_name": "CAROL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-10",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "PTL5471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "GRONBERG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dedham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.