Revere Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

343 Issued in MA

Legal business name

REVERE PHYSICAL THERAPY

Practice address

76 Shirley Ave
Revere, MA 02151-5102

Phone

(781) 284-8277

NPI assigned

Apr 15, 2008

Organization subpart

No

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

Authorized official

Name

Michael Prum

Title

Owner

Phone

(781) 284-8277

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William George Chapman, P.T.

  • Orthopedic Physical Therapist
  • Revere, MA
  • NPI 1477697308
  NPD (past)
• Jessica Rothwell Richard, M.S., P.T.

  • Physical Therapist
  • Revere, MA
  • NPI 1942361407
  NPD (past)

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1699949396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 SHIRLEY AVE",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021515102",
            "telephone_number": "781-284-8277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 SHIRLEY AVE",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021515102",
            "telephone_number": "781-284-8277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVERE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "PRUM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-284-8277"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MA",
            "license": "343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revere Dental and Orthodontics PC
• Revere Dentistry and Braces LLC
• Revere Health Center Pharmacy
• Revere Homecare Services
• Revere Pediatric Dentistry
• Revere Rehab, Inc.
• Revere Rehabilitation Center
• Revere Winthrop Pediatrics
• Jessica Rothwell Richard, M.S., P.T.
• Ride Right Transportation, Inc

• Physical Therapy Clinic/Center in Revere, MA
• Providers in Revere, MA by specialty
• Physical Therapy Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.