Individual provider Active NPI

Lauren Bennett

  • Physical Therapist
  • Woburn, MA
National Provider Identifier
1346853009
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25075 Issued in MA
Practice address
78C Olympia Ave
Woburn, MA 01801-2057
Phone
(781) 935-7701
NPI assigned
Aug 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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 25075 MA Primary

Addresses

Primary practice location

78C Olympia Ave
Woburn, MA 01801-2057

Mailing address

78C Olympia Ave
Woburn, MA 01801-2057
Phone (781) 935-7701

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

LicenseStateTypeSpecialty
25075MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Winning Edge Physical Therapy CurrentSince Aug 30, 2020 Accepting new patients
The Lifelong Athlete, PLLC Current Accepting new patients
Athletic Evolution Strength and Conditioning, Inc Physical Therapist Past Accepting new patients

Locations

78C Olympia Ave
Woburn, MA 01801
Phone (781) 935-7701

Organizations & group practices 3

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": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1346853009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78C OLYMPIA AVE",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018012057",
            "telephone_number": "781-935-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78C OLYMPIA AVE",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018012057",
            "telephone_number": "781-935-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-24",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "25075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.