Individual provider Active NPI

Kimberly A Maclauchlan, PT

  • Physical Therapist
  • Methuen, MA
National Provider Identifier
1629091293
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9936 Issued in MA
Practice address
225 Broadway Ste 201
Methuen, MA 01844-3261
Phone
(978) 455-4254
Fax
(978) 455-5083
NPI assigned
Jul 25, 2006
Last updated
Mar 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Physical Therapist 225100000X 9936 MA Primary

Addresses

Primary practice location

225 Broadway Ste 201
Methuen, MA 01844-3261

Mailing address

3 Red Fox Rd
Windham, NH 03087-1569
Phone (617) 549-7921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090402000334 MA Practitioner - Physical Therapist in Private Practice 8022165349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

225 Broadway
Suite 201
Methuen, MA 01844-3261
Phone (978) 455-4254

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9936MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Homecare LLC Current Accepting new patients
Community Resource Solutions Inc PastSince Mar 6, 2019 Accepting new patients
Cliftondale Physical Therapy Past Accepting new patients

Locations

225 Broadway
Ste 201
Methuen, MA 01844
Phone (978) 455-4254

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Precision Homecare LLCMethuen, MA, CCN 227760 Home health agency 5% Or Greater Direct Ownership Interest (49%) Apr 5, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1629091293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 RED FOX RD",
            "city": "WINDHAM",
            "state": "NH",
            "postal_code": "030871569",
            "telephone_number": "617-549-7921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 BROADWAY STE 201",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018443261",
            "telephone_number": "978-455-4254",
            "fax_number": "978-455-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACLAUCHLAN",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "9936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Methuen, MA

Sources for this page

Verify at the official NPI Registry.