Individual provider Active NPI

Kevin Coughlin, DPT, PT

  • Physical Therapist
  • Burlington, MA
National Provider Identifier
1609424894
Registry record updated Aug 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24519 Issued in MA
Practice address
54 Middlesex Tpke Ste 202
Burlington, MA 01803-4908
Phone
(781) 323-4116
Fax
(781) 365-2014
NPI assigned
Aug 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 24519 MA Primary

Addresses

Primary practice location

54 Middlesex Tpke Ste 202
Burlington, MA 01803-4908

Mailing address

1 Credit Union Way FL 3
Randolph, MA 02368-4633
Phone (781) 961-3370

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

State licenses

LicenseStateTypeSpecialty
24519MAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1609424894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CREDIT UNION WAY FL 3",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684633",
            "telephone_number": "781-961-3370",
            "fax_number": "781-961-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 MIDDLESEX TPKE STE 202",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018034908",
            "telephone_number": "781-323-4116",
            "fax_number": "781-365-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUGHLIN",
        "first_name": "KEVIN",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-30",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "24519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; 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.