Jonathan Michael Provost, PT, DPT, SCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

21309 Issued in MA

Practice address

241 Russell St
Hadley, MA 01035-9558

Phone

(413) 586-5552

NPI assigned

Aug 26, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Aegis Health Partners, P.C.

  • Physical Therapist
  • Hadley, MA
  • NPI 1508087024
  NPD
• Aegis Health Partners, P.C.

  • Chiropractor
  • Hadley, MA
  • NPI 1588853477
  NPD (past)
• Sports and Orthopedic Rehabilitation Services Inc

  • Physical Therapy Clinic/Center
  • Palm Harbor, FL
  • NPI 1932109071
  NPD (past)

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1619377751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 RUSSELL ST",
            "city": "HADLEY",
            "state": "MA",
            "postal_code": "010359558",
            "telephone_number": "413-586-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 RUSSELL ST",
            "city": "HADLEY",
            "state": "MA",
            "postal_code": "010359558",
            "telephone_number": "413-586-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVOST",
        "first_name": "JONATHAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, SCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-26",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "21309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Plansky, LCSW
• Katherine Prajzner, MA CCC-SLP
• Precision Dental Associates LLC
• Precision Dental Associates of Hadley LLC
• Kai Pretto, CCC-SLP
• R Christopher & Associates
• Deborah Reed, AU.D.,CCC-A, F-AAA
• Restore Physical Therapy and Wellness Center Inc.
• Rise Communication Clinic PLLC
• River Valley Bodyworks Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; 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.