Active NPI
Renee Scott-Packard, PT
- Physical Therapist
- Plymouth, MA
National Provider Identifier
1790255651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11665
- Practice address
- 20 N Park Ave
Plymouth, MA 02360-4090 - Phone
- (508) 830-6990
- NPI assigned
- Dec 4, 2018
- 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 | 11665 | MA | Primary |
Addresses
Primary practice location
20 N Park Ave
Plymouth, MA 02360-4090
Mailing address
139 Summit Ave
Quincy, MA 02170-3616
Phone (617) 688-0639
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 |
|---|---|---|---|
| 11665 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543881600000",
"number": "1790255651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "139 SUMMIT AVE",
"city": "QUINCY",
"state": "MA",
"postal_code": "021703616",
"telephone_number": "617-688-0639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 N PARK AVE",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "023604090",
"telephone_number": "508-830-6990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOTT-PACKARD",
"first_name": "RENEE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-04",
"last_updated": "2018-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "11665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.