Jessica Renee Doherty, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

16446 Issued in MA

Practice address

33 High St
Wilmington, MA 01887-1466

Phone

(617) 733-8233

NPI assigned

Mar 19, 2007

Last updated

Jul 4, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Renee Gladu Former name

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fox Rehab Ma LLC

  • Physical Therapist
  • Waltham, MA
  • NPI 1497174437
  Medicare reassignment NPD

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404432000000",
    "number": "1689799967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 HIGH ST",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018871466",
            "telephone_number": "617-733-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 HIGH ST",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018871466",
            "telephone_number": "617-733-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "JESSICA",
        "middle_name": "RENEE",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2014-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "16446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "GLADU",
            "middle_name": "RENEE",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessi Deveuve, RDN
• Chrys Diaz Dilone
• Julia N/a Difronzo, LAT, ATC
• Drew Diprimio
• Djkdmd, PC
• Ann Dopson
• Marie Francesse Dornevil
• Elizabeth Marie Doucet, RN
• Laurie Jean Dowling, RPH
• Kara M Downing, BCBA, LBA

• Physical Therapist in Wilmington, MA
• Providers in Wilmington, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.