Organization Active NPI

Western Mass. Physical Therapy, P.C.

  • Physical Therapist
  • Pittsfield, MA
National Provider Identifier
1487664967
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
WESTERN MASS. PHYSICAL THERAPY, P.C.
Practice address
290 1St St
Pittsfield, MA 01201-4751
Phone
(413) 443-4246
Fax
(413) 443-0737
NPI assigned
Aug 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Randy H Porter
Title
Business Manager
Phone
(413) 443-4246

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X MA Primary

Addresses

Primary practice location

290 1St St
Pittsfield, MA 01201-4751

Mailing address

290 1St St
Pittsfield, MA 01201-4751
Phone (413) 443-4246

Other identifiers 2

IdentifierTypeStateIssuer
Y65606OtherMABC/BS
9759441MedicaidMA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487664967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 1ST ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014751",
            "telephone_number": "413-443-4246",
            "fax_number": "413-443-0737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 1ST ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014751",
            "telephone_number": "413-443-4246",
            "fax_number": "413-443-0737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN MASS. PHYSICAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "413-443-4246"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "Y65606",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9759441",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.