NPIMap

Organization Active NPI

Mind-Body Connection, LLC

  • Physical Medicine & Rehabilitation Physician
  • Canton, MA
National Provider Identifier
1497045918
Registry record updated May 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
17793 Issued in MA
Legal business name
MIND-BODY CONNECTION, LLC
Practice address
401 Neponset St
Suite 3
Canton, MA 02021-1937
Phone
(781) 821-7477
Fax
(781) 821-7447
NPI assigned
Apr 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2011

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

Authorized official

Name
Ellen Spicuzza, APRN, ONS
Title
Owner
Phone
(781) 821-7477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 17793 MA Primary

Addresses

Primary practice location

401 Neponset St
Suite 3
Canton, MA 02021-1937

Mailing address

401 Neponset St
Suite 3
Canton, MA 02021-1937
Phone (781) 821-7477

National Provider Directory

National Provider Directory

Locations

401 Neponset St
Canton, MA 02021
Phone (781) 821-7477

401 Neponset St
Ste 3
Canton, MA 02021
Phone (781) 821-7477

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305504000000",
    "number": "1497045918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 NEPONSET ST",
            "address_2": "SUITE 3",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020211937",
            "telephone_number": "781-821-7477",
            "fax_number": "781-821-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 NEPONSET ST",
            "address_2": "SUITE 3",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020211937",
            "telephone_number": "781-821-7477",
            "fax_number": "781-821-7447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND-BODY CONNECTION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-18",
        "last_updated": "2011-05-16",
        "status": "A",
        "authorized_official_last_name": "SPICUZZA",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-821-7477",
        "authorized_official_credential": "APRN, ONS"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MA",
            "license": "17793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2011; 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.