NPIMap

Organization Active NPI

Criterion

  • Physical Therapy Clinic/Center
  • Jefferson, MA
National Provider Identifier
1669898714
Registry record updated Mar 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
5211 Issued in MA
Legal business name
CRITERION
Practice address
15 Manning St
Jefferson, MA 01522-1570
Phone
(508) 825-0621
NPI assigned
Mar 13, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2014

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

Authorized official

Name
Ms. Sally Goodhile
Title
Physical Therapist
Phone
(978) 632-4423

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 172V00000X
In Home Supportive Care Agency 253Z00000X 5211 MA
Physical Therapy Clinic/Center 261QP2000X 5211 MA Primary
Exclusive Provider Organization 302F00000X 5211 MA

Addresses

Primary practice location

15 Manning St
Jefferson, MA 01522-1570

Mailing address

31 Lake St
180
Gardner, MA 01440-3879
Phone (978) 632-4432

Other names 1

  • wachusett Doing business as

National Provider Directory

National Provider Directory

Locations

31 Lake St
Ste 180
Gardner, MA 01440
Phone (978) 632-4432

Practitioners & affiliated clinicians

Practitioners 4

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": "1394668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394668800000",
    "number": "1669898714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 LAKE ST",
            "address_2": "180",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014403879",
            "telephone_number": "978-632-4432",
            "fax_number": "978-632-6022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MANNING ST",
            "city": "JEFFERSON",
            "state": "MA",
            "postal_code": "015221570",
            "telephone_number": "508-825-0621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRITERION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-13",
        "last_updated": "2014-03-13",
        "status": "A",
        "authorized_official_last_name": "GOODHILE",
        "authorized_official_first_name": "SALLY",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "978-632-4423",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "MA",
            "license": "5211",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MA",
            "license": "5211",
            "primary": true
        },
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MA",
            "license": "5211",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "wachusett",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.