Active NPI
Derith Fernandes, DPT
- Physical Therapist
- Wakefield, MA
National Provider Identifier
1518352558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 21572
- Practice address
- 414 Main St
Wakefield, MA 01880-3018 - Phone
- (781) 245-0055
- NPI assigned
- Apr 6, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 21572 | MA | Primary |
Addresses
Primary practice location
414 Main St
Wakefield, MA 01880-3018
Mailing address
10 Fredrickson Rd
Billerica, MA 01821-5313
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428278400000",
"number": "1518352558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 FREDRICKSON RD",
"city": "BILLERICA",
"state": "MA",
"postal_code": "018215313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 MAIN ST",
"city": "WAKEFIELD",
"state": "MA",
"postal_code": "018803018",
"telephone_number": "781-245-0055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDES",
"first_name": "DERITH",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-06",
"last_updated": "2015-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "21572",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wakefield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.