Active NPI
Johanna Costello
- Physical Therapy Assistant
- Hyannis, MA
National Provider Identifier
1487048666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 9003
- Practice address
- 17 Pontiac St Apt 8
Hyannis, MA 02601-2477 - Phone
- (330) 322-5302
- NPI assigned
- Mar 25, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 9003 | MA | Primary |
| Physical Therapy Assistant | 225200000X | 01440 | OH |
Addresses
Primary practice location
17 Pontiac St Apt 8
Hyannis, MA 02601-2477
Mailing address
17 Pontiac St Apt 8
Hyannis, MA 02601-2477
Phone (330) 322-5302
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 |
|---|---|---|---|
| 01440 | OH | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427241600000",
"number": "1487048666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 PONTIAC ST APT 8",
"city": "HYANNIS",
"state": "MA",
"postal_code": "026012477",
"telephone_number": "330-322-5302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 PONTIAC ST APT 8",
"city": "HYANNIS",
"state": "MA",
"postal_code": "026012477",
"telephone_number": "330-322-5302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTELLO",
"first_name": "JOHANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-25",
"last_updated": "2015-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MA",
"license": "9003",
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OH",
"license": "01440",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hyannis, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.