Active NPI
White'S Physical Therapy & Bodymechanix, LLC
- Sports Physical Therapist
- Wilmington, MA
National Provider Identifier
1790713485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physical Therapist
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | |||
| Sports Physical Therapist | 2251S0007X | Primary | ||
| Orthopedic Physical Therapist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 619996 | Other | MA | TUFTS |
| Y61369 | Other | MA | BC/BS |
| 0308943 | Medicaid | MA |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Physical Therapist
- Amherst, NH
- NPI 1164531133
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.