Active NPI
Mary Lou Jones, P.T.
- Physical Therapist
- Essex, CT
National Provider Identifier
1710264221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 009054
- Practice address
- 12 Bokum Rd
Essex, CT 06426-1500 - Phone
- (860) 767-9053
- Fax
- (860) 767-1146
- NPI assigned
- Nov 11, 2011
- Sex
- Female
- 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 Therapist | 225100000X | 009054 | CT | Primary |
Addresses
Primary practice location
12 Bokum Rd
Essex, CT 06426-1500
Mailing address
12 Bokum Rd
Essex, CT 06426-1500
Phone (860) 767-9053
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
| License | State | Type | Specialty |
|---|---|---|---|
| 009054 | CT | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475107200000",
"number": "1710264221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 BOKUM RD",
"city": "ESSEX",
"state": "CT",
"postal_code": "064261500",
"telephone_number": "860-767-9053",
"fax_number": "860-767-1146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 BOKUM RD",
"city": "ESSEX",
"state": "CT",
"postal_code": "064261500",
"telephone_number": "860-767-9053",
"fax_number": "860-767-1146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "MARY",
"middle_name": "LOU",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-11",
"last_updated": "2016-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "009054",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Essex, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.