NPIMap

Organization Active NPI

Marathon Physical Therapy and Sports Medicine, LLC

  • Physical Therapist
  • Newton, MA
National Provider Identifier
1346373115
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
274 Issued in MA
Legal business name
MARATHON PHYSICAL THERAPY AND SPORTS MEDICINE, LLC
Practice address
425 Centre St
Newton, MA 02458-2063
Phone
(617) 244-1990
Fax
(617) 244-1811
NPI assigned
Mar 13, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Jessica Leigh McKinney, MS, PTNPI 1215088679
Title
Co-Owner
Phone
(508) 285-5533

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 274 MA Primary

Addresses

Primary practice location

425 Centre St
Newton, MA 02458-2063

Mailing address

250 E Main St
Norton, MA 02766-2436
Phone (508) 285-5533

Other identifiers 5

IdentifierTypeStateIssuer
AA9925OtherMAHPHC
Y61396OtherMABCBS-MA
9729691MedicaidMA
602335OtherMATUFTS HEALTH PLAN
0033550OtherMANEIGHBORHOOD HEALTH PLAN

National Provider Directory

National Provider Directory
Tax ID family
Marathon Physical Therapy and Sports Medicine LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 51

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346373115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E MAIN ST",
            "city": "NORTON",
            "state": "MA",
            "postal_code": "027662436",
            "telephone_number": "508-285-5533",
            "fax_number": "508-285-7977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 CENTRE ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024582063",
            "telephone_number": "617-244-1990",
            "fax_number": "617-244-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARATHON PHYSICAL THERAPY AND SPORTS MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCKINNEY",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "508-285-5533",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "AA9925",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-MA",
            "identifier": "Y61396",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9729691",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "602335",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0033550",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.