Theodora Colburn, BA BS RN

Primary specialty

Nurse Massage Therapist (NMT)Taxonomy code 163WM1400X

License

RN118502 Issued in MA

Practice address

38 Olmstead St
Jamaica Plain, MA 02130-2910

Phone

(617) 514-1515

Fax

(617) 083-5610

NPI assigned

Jul 20, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts, Bachelor of Science, Registered Nurse

State licenses

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342742400000",
    "number": "1508111964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 OLMSTEAD STREET",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "02130",
            "telephone_number": "617-514-1515",
            "fax_number": "617-083-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 OLMSTEAD ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302910",
            "telephone_number": "617-514-1515",
            "fax_number": "617-083-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBURN",
        "first_name": "THEODORA",
        "name_prefix": "Mrs.",
        "credential": "BA BS RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-20",
        "last_updated": "2012-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM1400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nurse Massage Therapist (NMT)",
            "state": "MA",
            "license": "RN118502",
            "primary": true
        },
        {
            "code": "364SR0400X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Rehabilitation",
            "state": "MA",
            "license": "RN118502",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosemarie Coelho, MSW, LICSW
• Yolanda Nicole Coentro, LICSW
• Jeffrey S Cohen, MD
• Leslie Gerald Cohen, MD
• Matt Cohen
• Stephen Colchamiro, DMD
• Allison Cole
• Carolyn Coleman, MSW
• Isabel Collazo
• Allison Elizabeth Collins, PH.D.

• Nurse Massage Therapist (NMT) in Jamaica Plain, MA
• Providers in Jamaica Plain, MA by specialty
• Nurse Massage Therapist (NMT) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; 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.