Active NPI
Mary Louise Waterman, PT
- Physical Therapist
- Woburn, MA
National Provider Identifier
1780865238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501
- Practice address
- Criterion-Stoneham Early Intervention Program
8 Henshaw St
Woburn, MA 01801 - Phone
- (781) 935-3855
- Fax
- (781) 935-5250
- NPI assigned
- Nov 26, 2007
- 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 | 5501 | MA | Primary |
Addresses
Primary practice location
Criterion-Stoneham Early Intervention Program
8 Henshaw St
Woburn, MA 01801
Mailing address
8 Henshaw St
Suite F
Woburn, MA 01801-4624
Phone (781) 935-3855
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 |
|---|---|---|---|
| 5501 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196035200000",
"number": "1780865238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 HENSHAW ST",
"address_2": "SUITE F",
"city": "WOBURN",
"state": "MA",
"postal_code": "018014624",
"telephone_number": "781-935-3855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CRITERION-STONEHAM EARLY INTERVENTION PROGRAM",
"address_2": "8 HENSHAW ST",
"city": "WOBURN",
"state": "MA",
"postal_code": "01801",
"telephone_number": "781-935-3855",
"fax_number": "781-935-5250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERMAN",
"first_name": "MARY",
"middle_name": "LOUISE",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-26",
"last_updated": "2007-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "5501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woburn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.