Active NPI
Kelly M McDermott, DPT, ATC
- Home Health Agency
- Burlington, MA
National Provider Identifier
1639216757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 8513
- Practice address
- 111 S Bedford St
Burlington, MA 01803-5145 - Phone
- (781) 272-2100
- Fax
- (781) 272-0404
- NPI assigned
- Jan 30, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 8513 | MA | Primary |
Addresses
Primary practice location
111 S Bedford St
Burlington, MA 01803-5145
Mailing address
16 Cleveland St
Arlington, MA 02474-6916
Phone (781) 641-4168
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8513 | MA | MD | Home Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639216757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 CLEVELAND ST",
"city": "ARLINGTON",
"state": "MA",
"postal_code": "024746916",
"telephone_number": "781-641-4168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 S BEDFORD ST",
"city": "BURLINGTON",
"state": "MA",
"postal_code": "018035145",
"telephone_number": "781-272-2100",
"fax_number": "781-272-0404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDERMOTT",
"first_name": "KELLY",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DPT, ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "MA",
"license": "8513",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.