Active NPI
Kimberly Glow
- Physical Therapist
- Norwood, MA
National Provider Identifier
1396137089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 21544
- Practice address
- 99 Vanderbilt Ave
Norwood, MA 02062-5011 - Phone
- (781) 352-5400
- Fax
- (781) 352-5401
- NPI assigned
- Mar 4, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 21544 | MA | Primary |
Addresses
Primary practice location
99 Vanderbilt Ave
Norwood, MA 02062-5011
Mailing address
250 E Main St
Suite 10
Norton, MA 02766-2436
Phone (508) 285-5533
Other names 1
- Kimberly Deane
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
| License | State | Type | Specialty |
|---|---|---|---|
| 21544 | MA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marathon Physical Therapy and Sports Medicine, LLC | Physical Therapist | Past | Accepting new patients |
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.
-
- Physical Therapist
- Newton, MA
- NPI 1346373115
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442966400000",
"number": "1396137089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 E MAIN ST",
"address_2": "SUITE 10",
"city": "NORTON",
"state": "MA",
"postal_code": "027662436",
"telephone_number": "508-285-5533",
"fax_number": "508-285-4483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 VANDERBILT AVE",
"city": "NORWOOD",
"state": "MA",
"postal_code": "020625011",
"telephone_number": "781-352-5400",
"fax_number": "781-352-5401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLOW",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-04",
"last_updated": "2015-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "21544",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KIMBERLY",
"last_name": "DEANE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Norwood, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.