Individual provider Active NPI

Ann Marie Goncalves, PT

  • Physical Therapist
  • Pawtucket, RI
National Provider Identifier
1386814614
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT02141 Issued in RI
Practice address
407 East Ave
Suite 110
Pawtucket, RI 02860-5299
Phone
(401) 722-2225
Fax
(401) 722-2235
NPI assigned
Mar 3, 2008
Last updated
Mar 3, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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 PT02141 RI Primary

Addresses

Primary practice location

407 East Ave
Suite 110
Pawtucket, RI 02860-5299

Mailing address

407 East Ave
Suite 110
Pawtucket, RI 02860-5299
Phone (401) 722-2225

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

NPI Registry JSON

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1386814614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 EAST AVE",
            "address_2": "SUITE 110",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605299",
            "telephone_number": "401-722-2225",
            "fax_number": "401-722-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 EAST AVE",
            "address_2": "SUITE 110",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605299",
            "telephone_number": "401-722-2225",
            "fax_number": "401-722-2235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONCALVES",
        "first_name": "ANN MARIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-03",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT02141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.

Verify at the official NPI Registry.