Individual provider Active NPI

Lauren Anne Dickerman, DPT

  • Physical Therapist
  • Newton, MA
National Provider Identifier
1710233382
Registry record updated Sep 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20046 Issued in MA
Practice address
425 Centre St
Newton, MA 02458-2063
Phone
(617) 244-1990
Fax
(617) 244-1811
NPI assigned
Aug 1, 2012
Last updated
Sep 11, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 20046 MA Primary

Addresses

Primary practice location

425 Centre St
Newton, MA 02458-2063

Mailing address

250 E Main St
Norton, MA 02766-2436
Phone (508) 285-5533

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
20046MAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Marathon Physical Therapy and Sports Medicine, LLC Physical Therapist CurrentSince Aug 6, 2012 Accepting new patients
Motion Works Physical Therapy, LLC Physical Therapist CurrentSince Nov 15, 2021 Accepting new patients
Marathon Physical Therapy and Sports Medicine, LLC Physical Therapist Past Accepting new patients

Locations

425 Centre St
Newton, MA 02458
Phone (617) 244-1990

250 E Main St
Norton, MA 02766
Phone (508) 285-5533

99 Vanderbilt Ave
Norwood, MA 02062
Phone (781) 352-5400

1333 Main St
Ste G
Walpole, MA 02081
Phone (508) 668-8900

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505088000000",
    "number": "1710233382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E MAIN ST",
            "city": "NORTON",
            "state": "MA",
            "postal_code": "027662436",
            "telephone_number": "508-285-5533",
            "fax_number": "508-285-7977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 CENTRE ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024582063",
            "telephone_number": "617-244-1990",
            "fax_number": "617-244-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERMAN",
        "first_name": "LAUREN",
        "middle_name": "ANNE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-01",
        "last_updated": "2017-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "20046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2017; 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.