NPIMap

Organization Active NPI

Kennedy Brothers Physical Therapy Inc.

  • Physical Therapist
  • Watertown, MA
National Provider Identifier
1811063803
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
KENNEDY BROTHERS PHYSICAL THERAPY INC.
Doing business as
Kennedy Brothers Physical Therapy Inc.
Practice address
85 Main St
Ste 103
Watertown, MA 02472
Phone
(617) 924-5100
Fax
(617) 924-5199
NPI assigned
Nov 28, 2006
Last updated
Jun 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Authorized official

Name
Laura J Collins
Title
Administrator
Phone
(617) 372-6317

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081S0010X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

85 Main St
Ste 103
Watertown, MA 02472

Mailing address

85 Main St
Ste 103
Watertown, MA 02472
Phone (617) 924-5100

Other practice location 1

25 Braintree Hill Office Park
Braintree, MA 02184-8702
Phone (781) 848-7300

Other practice location 2

790 Chief Justice Cushing Hwy
Cohasset, MA 02025-2140
Phone (781) 383-8001

Other identifiers 3

IdentifierTypeStateIssuer
605690OtherMAHARVARD PILGRIM PIN
0000Y65622OtherMABCBS PIN
717236OtherMATUFTS PIN

Other names 1

  • Kennedy Brothers Physical Therapy Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kennedy Brothers Physical Therapy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

45 Franklin St
Fl 2
Boston, MA 02110
Phone (617) 542-6611

505 Boylston St
Boston, MA 02116
Phone (617) 266-2664

633 Highland Ave
Needham Heights, MA 02494
Phone (781) 444-1416

124 Watertown St
Ste 1F
Watertown, MA 02472
Phone (617) 924-5100

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1811063803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 MAIN ST",
            "address_2": "STE 103",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "02472",
            "telephone_number": "617-924-5100",
            "fax_number": "617-924-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 MAIN ST",
            "address_2": "STE 103",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "02472",
            "telephone_number": "617-924-5100",
            "fax_number": "617-924-5199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Braintree Hill Office Park",
            "address_purpose": "LOCATION",
            "city": "Braintree",
            "state": "MA",
            "postal_code": "021848702",
            "country_code": "US",
            "telephone_number": "781-848-7300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "790 Chief Justice Cushing Hwy",
            "address_purpose": "LOCATION",
            "city": "Cohasset",
            "state": "MA",
            "postal_code": "020252140",
            "country_code": "US",
            "telephone_number": "781-383-8001",
            "fax_number": "781-383-8009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KENNEDY BROTHERS PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "617-372-6317"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM PIN",
            "identifier": "605690",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "0000Y65622",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS PIN",
            "identifier": "717236",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kennedy Brothers Physical Therapy Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Watertown, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.