NPIMap

Individual provider Active NPI

Jill Marie D'Entremont, P.T.A.

  • Physical Therapy Assistant
  • Salem, MA
National Provider Identifier
1679879175
Registry record updated Jan 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
7932 Issued in MA
Practice address
84 Highland Ave
Suite 201
Salem, MA 01970-2727
Phone
(978) 741-0880
Fax
(978) 741-5595
NPI assigned
Jan 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 7932 MA Primary

Addresses

Primary practice location

84 Highland Ave
Suite 201
Salem, MA 01970-2727

Mailing address

84 Highland Ave
Suite 201
Salem, MA 01970-2727
Phone (978) 741-0880

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

NPI Registry JSON

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

{
    "created_epoch": "1296432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296432000000",
    "number": "1679879175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 HIGHLAND AVE",
            "address_2": "SUITE 201",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702727",
            "telephone_number": "978-741-0880",
            "fax_number": "978-741-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 HIGHLAND AVE",
            "address_2": "SUITE 201",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702727",
            "telephone_number": "978-741-0880",
            "fax_number": "978-741-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ENTREMONT",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-31",
        "last_updated": "2011-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "7932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2011; 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.