Active NPI
Stephen Blanch, PTA
- Physical Therapy Assistant
- Weymouth, MA
National Provider Identifier
1700273695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 8904
- Practice address
- 125 Broad St
Weymouth, MA 02188-2336 - Phone
- (781) 377-3121
- NPI assigned
- Apr 19, 2015
- Sex
- Male
- Sole proprietor
- No
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 | 8904 | MA | Primary |
Addresses
Primary practice location
125 Broad St
Weymouth, MA 02188-2336
Mailing address
11 Front St
Apt 110
Weymouth, MA 02188-1629
Phone (518) 376-9945
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 |
|---|---|---|---|
| 8904 | MA | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429401600000",
"number": "1700273695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 FRONT ST",
"address_2": "APT 110",
"city": "WEYMOUTH",
"state": "MA",
"postal_code": "021881629",
"telephone_number": "518-376-9945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 BROAD ST",
"city": "WEYMOUTH",
"state": "MA",
"postal_code": "021882336",
"telephone_number": "781-377-3121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANCH",
"first_name": "STEPHEN",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-19",
"last_updated": "2015-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MA",
"license": "8904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weymouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.