Joan Waceke Wambaa, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

17745 Issued in MA

Practice address

75 Francis St
Boston, MA 02115-6110

Phone

(617) 732-6853

Fax

(617) 277-1078

NPI assigned

Aug 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Joanne Waceke Wambaa Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186963200000",
    "number": "1518159755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 STRATHMORE RD",
            "address_2": "5",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021355212",
            "telephone_number": "423-612-3416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-6853",
            "fax_number": "617-277-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAMBAA",
        "first_name": "JOAN",
        "middle_name": "WACEKE",
        "name_prefix": "Ms.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-13",
        "last_updated": "2007-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "17745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANNE",
            "last_name": "WAMBAA",
            "middle_name": "WACEKE",
            "credential": "MPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Zandra Elene Walton, MD-PHD
• David A Waltz, MD
• Toni Beth Walzer, MD
• Bridgette Wamakima, MD/MBA
• Isaac Wamala, M.D
• Chidi Wamuo, MD
• Bing Chiang Wan, D.M.D.
• Michael Wan, M.D., B.SC.
• Victor Wan, MD
• Winnie W Wan, PHARMD

• Physical Therapist in Boston, MA
• Providers in Boston, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; 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.