The Village-Child & Family Development, Inc

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

11745 Issued in MA

Legal business name

THE VILLAGE-CHILD & FAMILY DEVELOPMENT, INC

Practice address

25 Adams St
Braintree, MA 02184-1911

Phone

(781) 269-2323

NPI assigned

Oct 15, 2012

Last updated

Oct 15, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Cassandra A Clark, MS, OTR/L

Title

Owner

Phone

(781) 269-2323

Specialties & licenses 3

Addresses

Other identifiers 1

Tax ID family

The Village-Child Family Development Inc3 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.

• The Village-Child & Family Development, Inc

  • Speech-Language Pathologist
  • Braintree, MA
  • NPI 1538411715
  NPD tax ID
• The Village-Child & Family Development, Inc.

  • Pediatric Occupational Therapist
  • Braintree, MA
  • NPI 1376825711
  NPD tax ID

Locations

Practitioners 1

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.

• Pamela J Leblanc, OTR/L

  • Occupational Therapist
  • Braintree, MA
  • NPI 1548512296
  NPD (past)

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

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350259200000",
    "number": "1396097309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 SHADE ST",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023681769",
            "telephone_number": "781-269-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 ADAMS ST",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021841911",
            "telephone_number": "781-269-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE VILLAGE-CHILD & FAMILY DEVELOPMENT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-15",
        "last_updated": "2012-10-15",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-269-2323",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, OTR/L"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MA",
            "license": "11745",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MA",
            "license": "19782",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MA",
            "license": "6919",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110093137A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Physical Therapist in Braintree, MA
• Providers in Braintree, MA by specialty
• Pediatric Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; 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.