Individual provider Active NPI

Kimberly Depardo, PTA

  • Physical Therapy Assistant
  • Methuen, MA
National Provider Identifier
1477433233
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA2791 Issued in MA
Practice address
14 Ingalls CT
Methuen, MA 01844-3717
Phone
(978) 686-2807
NPI assigned
Sep 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA2791 MA Primary
Physical Therapy Assistant 225200000X 2007 NH

Addresses

Primary practice location

14 Ingalls CT
Methuen, MA 01844-3717

Mailing address

14 Ingalls CT
Methuen, MA 01844-3717
Phone (978) 686-2807

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
PTA2791MAMDPhysical Therapy Assistant
2007NHMDPhysical Therapy Assistant

Interoperability endpoints

  • Direct secure messaging: kimberly.depardo.p1@direct.elementcare.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1756857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1477433233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 INGALLS CT",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018443717",
            "telephone_number": "978-686-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 INGALLS CT",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018443717",
            "telephone_number": "978-686-2807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPARDO",
        "first_name": "KIMBERLY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "PTA2791",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NH",
            "license": "2007",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Methuen, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; 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.