NPIMap

Organization Active NPI

North Shore Sports Medical Center of Danvers, LLC

  • Physical Therapist
  • Danvers, MA
National Provider Identifier
1619026879
Registry record updated Mar 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5094 Issued in MA
Legal business name
NORTH SHORE SPORTS MEDICAL CENTER OF DANVERS, LLC
Practice address
4 State Road
Danvers, MA 01923
Phone
(978) 777-3220
Fax
(978) 774-5883
NPI assigned
Jan 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2013

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

Authorized official

Name
Mr. Michael J Lovett, PT
Title
Physical Therapist
Phone
(978) 777-3220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 5094 MA Primary

Addresses

Primary practice location

4 State Road
Danvers, MA 01923

Mailing address

4 State Rd
Danvers, MA 01923-2567
Phone (978) 777-3220

Other identifiers 3

IdentifierTypeStateIssuer
626072OtherMAHARVARD PILGRIM HEALTHCAR
711510OtherMATUFTS
0000Y65564OtherMABLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363046400000",
    "number": "1619026879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 STATE RD",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019232567",
            "telephone_number": "978-777-3220",
            "fax_number": "978-774-5883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 STATE ROAD",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "01923",
            "telephone_number": "978-777-3220",
            "fax_number": "978-774-5883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE SPORTS MEDICAL CENTER OF DANVERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2013-03-12",
        "status": "A",
        "authorized_official_last_name": "LOVETT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "978-777-3220",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "5094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "626072",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "711510",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0000Y65564",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; 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.