Individual provider Active NPI

Douglas J Perron, PTA

  • Physical Therapy Assistant
  • Foxborough, MA
National Provider Identifier
1407102932
Registry record updated Aug 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
3996 Issued in MA
Practice address
20 Patriot PL
Suite 220
Foxborough, MA 02035-1375
Phone
(508) 718-4107
Fax
(508) 718-4041
NPI assigned
Aug 2, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 3996 MA Primary

Addresses

Primary practice location

20 Patriot PL
Suite 220
Foxborough, MA 02035-1375

Mailing address

20 Patriot PL
Suite 220
Foxborough, MA 02035-1375
Phone (508) 718-4107

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3996MAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343865600000",
    "number": "1407102932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PATRIOT PL",
            "address_2": "SUITE 220",
            "city": "FOXBOROUGH",
            "state": "MA",
            "postal_code": "020351375",
            "telephone_number": "508-718-4107",
            "fax_number": "508-718-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PATRIOT PL",
            "address_2": "SUITE 220",
            "city": "FOXBOROUGH",
            "state": "MA",
            "postal_code": "020351375",
            "telephone_number": "508-718-4107",
            "fax_number": "508-718-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRON",
        "first_name": "DOUGLAS",
        "middle_name": "J",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-02",
        "last_updated": "2012-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "3996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Foxborough, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.