NPIMap

Organization Active NPI

Kane Square Physical Therapy, LLC

  • Physical Therapist
  • Dorchester, MA
National Provider Identifier
1700023090
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
481 Issued in MA
Legal business name
KANE SQUARE PHYSICAL THERAPY, LLC
Practice address
427 Bowdoin Street
Dorchester, MA 02122
Phone
(617) 825-7300
NPI assigned
Jan 8, 2009
Last updated
Jan 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

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

Authorized official

Name
Ana C Correia
Title
Owner
Phone
(617) 233-1583

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 481 MA Primary

Addresses

Primary practice location

427 Bowdoin Street
Dorchester, MA 02122

Mailing address

P. O. Box 256110
Dorchester, MA 02125
Phone (617) 825-7300

National Provider Directory

National Provider Directory

Locations

427 Bowdoin St
Dorchester, MA 02122
Phone (617) 825-7300

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1700023090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 256110",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "02125",
            "telephone_number": "617-825-7300",
            "fax_number": "617-825-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 BOWDOIN STREET",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "02122",
            "telephone_number": "617-825-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANE SQUARE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "CORREIA",
        "authorized_official_first_name": "ANA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-233-1583"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.