Mariam Adili Skinner, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

16020 Issued in MA

Practice address

1180 Beacon St
Suite 6C
Brookline, MA 02446-3885

Phone

(617) 730-5337

NPI assigned

Sep 22, 2006

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 identifiers 3

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239235200000",
    "number": "1598864696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1913 COMMONWEALTH AVE",
            "city": "AUBURNDALE",
            "state": "MA",
            "postal_code": "024662417",
            "telephone_number": "617-730-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 BEACON ST",
            "address_2": "SUITE 6C",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463885",
            "telephone_number": "617-730-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADILI SKINNER",
        "first_name": "MARIAM",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2009-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "16020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "Y38139",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATENA",
            "identifier": "3138008",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "470287",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; 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.