Individual provider Active NPI

Jamie B Galvin, PTA

  • Specialist
  • Haverhill, MA
National Provider Identifier
1588079610
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
190 North Ave
Haverhill, MA 01830-2238
Phone
(978) 372-7700
NPI assigned
Jun 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 9152 MA
Specialist 174400000X Primary

Addresses

Primary practice location

190 North Ave
Haverhill, MA 01830-2238

Mailing address

49 Buttonwoods Ave
Haverhill, MA 01830-6453
Phone (603) 913-5928

Other practice location 1

64 Main St
Keene, NH 03431-3701
Phone (603) 283-1570

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

LicenseStateTypeSpecialty
9152MAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1588079610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 BUTTONWOODS AVE",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306453",
            "telephone_number": "603-913-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 NORTH AVE",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018302238",
            "telephone_number": "978-372-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "64 Main St",
            "address_purpose": "LOCATION",
            "city": "Keene",
            "state": "NH",
            "postal_code": "034313701",
            "country_code": "US",
            "telephone_number": "603-283-1570",
            "fax_number": "603-357-9648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALVIN",
        "first_name": "JAMIE",
        "middle_name": "B",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-27",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "9152",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haverhill, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; 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.