Active NPI
Gina L Kozimor, M.S.P.T.
- Physical Therapist
- Mansfield, MA
National Provider Identifier
1578682597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8934
- Practice address
- 200 Chauncy St
Suite 101
Mansfield, MA 02048-1200 - Phone
- (401) 486-1753
- NPI assigned
- Mar 29, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 8934 | MA | Primary |
Addresses
Primary practice location
200 Chauncy St
Suite 101
Mansfield, MA 02048-1200
Mailing address
200 Chauncy St
Suite 101
Mansfield, MA 02048-1200
Phone (401) 486-1753
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8934 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578682597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 CHAUNCY ST",
"address_2": "SUITE 101",
"city": "MANSFIELD",
"state": "MA",
"postal_code": "020481200",
"telephone_number": "401-486-1753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 CHAUNCY ST",
"address_2": "SUITE 101",
"city": "MANSFIELD",
"state": "MA",
"postal_code": "020481200",
"telephone_number": "401-486-1753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOZIMOR",
"first_name": "GINA",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "M.S.P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "8934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.