Organization Active NPI

White'S Physical Therapy & Bodymechanix, LLC

  • Sports Physical Therapist
  • Wilmington, MA
National Provider Identifier
1790713485
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
Legal business name
WHITE'S PHYSICAL THERAPY & BODYMECHANIX, LLC
Practice address
1 Burlington Ave
Wilmington, MA 01887-3926
Phone
(978) 658-5556
Fax
(978) 658-5269
NPI assigned
Jun 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Mr. Douglas E White, MSPT, L/ATC, CSCS
Title
Owner
Phone
(978) 568-5556

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Sports Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251S0007X Primary
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X

Addresses

Primary practice location

1 Burlington Ave
Wilmington, MA 01887-3926

Mailing address

PO Box 4053
Andover, MA 01810-0811
Phone (978) 658-5556

Other identifiers 3

IdentifierTypeStateIssuer
619996OtherMATUFTS
Y61369OtherMABC/BS
0308943MedicaidMA

National Provider Directory

National Provider Directory

Locations

1 Burlington Ave
Wilmington, MA 01887
Phone (231) 564-6389

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1790713485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4053",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018100811",
            "telephone_number": "978-658-5556",
            "fax_number": "978-658-5269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BURLINGTON AVE",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018873926",
            "telephone_number": "978-658-5556",
            "fax_number": "978-658-5269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE'S PHYSICAL THERAPY & BODYMECHANIX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-568-5556",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT, L/ATC, CSCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "619996",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "Y61369",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0308943",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.