Active NPI
Danielle Healy, PTA
- Physical Therapy Assistant
- Revere, MA
National Provider Identifier
1699380733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 9793
- Practice address
- 204 Proctor Ave
Revere, MA 02151-4923 - Phone
- (781) 286-3100
- NPI assigned
- Sep 15, 2020
- Last updated
- Sep 15, 2020
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 9793 | MA | Primary |
Addresses
Primary practice location
204 Proctor Ave
Revere, MA 02151-4923
Mailing address
205 Revere Beach Pkwy Unit 333
Revere, MA 02151-5439
Phone (339) 236-0766
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 |
|---|---|---|---|
| 9793 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600128000000",
"number": "1699380733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 REVERE BEACH PKWY UNIT 333",
"city": "REVERE",
"state": "MA",
"postal_code": "021515439",
"telephone_number": "339-236-0766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 PROCTOR AVE",
"city": "REVERE",
"state": "MA",
"postal_code": "021514923",
"telephone_number": "781-286-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEALY",
"first_name": "DANIELLE",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-15",
"last_updated": "2020-09-15",
"certification_date": "2020-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MA",
"license": "9793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Revere, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.