NPIMap

Individual provider Active NPI

Nandakumar Menon, PT

  • Physical Therapist
  • Concord, MA
National Provider Identifier
1659633105
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19040 Issued in MA
Practice address
26 Main St
Unit 1, 2ND Floor
Concord, MA 01742-2536
Phone
(339) 203-3893
NPI assigned
Jun 11, 2012
Last updated
Jun 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 19040 MA Primary
Geriatric Physical Therapist 2251G0304X 19040 MA
Orthopedic Physical Therapist 2251X0800X 19040 MA

Addresses

Primary practice location

26 Main St
Unit 1, 2ND Floor
Concord, MA 01742-2536

Mailing address

26 Main St
Unit 1, 2ND Floor
Concord, MA 01742-2536
Phone (339) 203-3893

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
19040MAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1659633105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 MAIN ST",
            "address_2": "UNIT 1, 2ND FLOOR",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422536",
            "telephone_number": "339-203-3893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 MAIN ST",
            "address_2": "UNIT 1, 2ND FLOOR",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422536",
            "telephone_number": "339-203-3893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENON",
        "first_name": "NANDAKUMAR",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-11",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "19040",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "MA",
            "license": "19040",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MA",
            "license": "19040",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; 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.