Active NPI
Jessica Carlson, PT, DPT
- Physical Therapist
- Boston, MA
National Provider Identifier
1740964360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 631 Tremont St Ste C
Boston, MA 02118-1256 - Phone
- (617) 859-6332
- NPI assigned
- Jun 14, 2023
- 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 | Primary |
Addresses
Primary practice location
631 Tremont St Ste C
Boston, MA 02118-1256
Mailing address
703 Granite St Ste 300
Braintree, MA 02184-5350
Phone (781) 807-6138
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686700800000",
"number": "1740964360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 GRANITE ST STE 300",
"city": "BRAINTREE",
"state": "MA",
"postal_code": "021845350",
"telephone_number": "781-807-6138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "631 TREMONT ST STE C",
"city": "BOSTON",
"state": "MA",
"postal_code": "021181256",
"telephone_number": "617-859-6332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "JESSICA",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-14",
"last_updated": "2023-06-14",
"certification_date": "2023-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.