NPIMap

Organization Active NPI

Nantucket Therapy, LLC

  • Speech-Language Pathologist
  • Nantucket, MA
National Provider Identifier
1801218797
Registry record updated Sep 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8082 Issued in MA
Legal business name
NANTUCKET THERAPY, LLC
Doing business as
Nantucket Therapy Center
Practice address
125 Orange St
Nantucket, MA 02554-4028
Phone
(508) 648-8348
Fax
(508) 796-6262
NPI assigned
Jan 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2014

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

Authorized official

Name
Carynne A Keyes, MA, CCC-SLP
Title
Owner/Director
Phone
(508) 648-8348

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 8082 MA Primary
Physical Therapy Clinic/Center 261QP2000X 8216 MA

Addresses

Primary practice location

125 Orange St
Nantucket, MA 02554-4028

Mailing address

125 Orange St
Nantucket, MA 02554-4028
Phone (508) 648-8348

Other identifiers 2

IdentifierTypeStateIssuer
110094575AMedicaidMA
0031240OtherMAPTAN

Other names 1

  • Nantucket Therapy Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411084800000",
    "number": "1801218797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 ORANGE ST",
            "city": "NANTUCKET",
            "state": "MA",
            "postal_code": "025544028",
            "telephone_number": "508-648-8348",
            "fax_number": "508-796-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 ORANGE ST",
            "city": "NANTUCKET",
            "state": "MA",
            "postal_code": "025544028",
            "telephone_number": "508-648-8348",
            "fax_number": "508-796-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANTUCKET THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-10",
        "last_updated": "2014-09-19",
        "status": "A",
        "authorized_official_last_name": "KEYES",
        "authorized_official_first_name": "CARYNNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "508-648-8348",
        "authorized_official_credential": "MA, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "8082",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MA",
            "license": "8216",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110094575A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "0031240",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nantucket Therapy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nantucket, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; 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.