Active NPI
Rachel Gibbons, MS, OTR/L
- Occupational Therapist
- Waltham, MA
National Provider Identifier
1417465832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 12611
- Practice address
- 179 Bear Hill Rd
Waltham, MA 02451 - Phone
- (781) 895-9500
- NPI assigned
- Jan 19, 2018
- Reactivated
- Apr 2, 2018
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 12611 | MA | Primary |
Addresses
Primary practice location
179 Bear Hill Rd
Waltham, MA 02451
Mailing address
179 Bear Hill Rd
Waltham, MA 02451
Phone (781) 895-9500
Other practice location 1
1 Grant St
Framingham, MA 01702-6764
Phone (401) 533-7505
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12611 | MA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523232000000",
"number": "1417465832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "179 BEAR HILL RD",
"city": "WALTHAM",
"state": "MA",
"postal_code": "02451",
"telephone_number": "781-895-9500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "179 BEAR HILL RD",
"city": "WALTHAM",
"state": "MA",
"postal_code": "02451",
"telephone_number": "781-895-9500"
}
],
"practiceLocations": [
{
"address_1": "1 Grant St",
"address_purpose": "LOCATION",
"city": "Framingham",
"state": "MA",
"postal_code": "017026764",
"country_code": "US",
"telephone_number": "401-533-7505",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GIBBONS",
"first_name": "RACHEL",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-19",
"last_updated": "2018-04-09",
"deactivation_date": "2018-03-07",
"reactivation_date": "2018-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "12611",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.