Active NPI
Lynne Ann Dutton, PTA
- Physical Therapy Assistant
- Agawam, MA
National Provider Identifier
1417526252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 3297
- Practice address
- 56 Fernwood Dr
Agawam, MA 01001-3029 - Phone
- (413) 786-4606
- NPI assigned
- Jun 24, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 225200000X | 3297 | MA | Primary |
Addresses
Primary practice location
56 Fernwood Dr
Agawam, MA 01001-3029
Mailing address
56 Fernwood Dr
Agawam, MA 01001-3029
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Rosepooh@comcast.net | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3297 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624492800000",
"number": "1417526252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 FERNWOOD DR",
"city": "AGAWAM",
"state": "MA",
"postal_code": "010013029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56 FERNWOOD DR",
"city": "AGAWAM",
"state": "MA",
"postal_code": "010013029",
"telephone_number": "413-786-4606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUTTON",
"first_name": "LYNNE",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-24",
"last_updated": "2021-06-24",
"certification_date": "2021-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MA",
"license": "3297",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Rosepooh@comcast.net",
"affiliation": "N",
"endpointDescription": "Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "56 Fernwood Dr",
"city": "Agawam",
"state": "MA",
"country_code": "US",
"postal_code": "010013029",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Agawam, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.