Active NPI
Randy Alex Jean, PT
- Physical Therapist
- Norwell, MA
National Provider Identifier
1831789932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 20197
- Practice address
- 143 Longwater Dr
Norwell, MA 02061-1683 - Phone
- (781) 878-5200
- NPI assigned
- Jan 22, 2021
- Sex
- Male
- 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 | 20197 | MA | Primary |
Addresses
Primary practice location
143 Longwater Dr
Norwell, MA 02061-1683
Mailing address
94 Eisenhower Dr
Brockton, MA 02302-1064
Phone (508) 577-9422
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 |
|---|---|---|---|
| 20197 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611273600000",
"number": "1831789932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94 EISENHOWER DR",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023021064",
"telephone_number": "508-577-9422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "143 LONGWATER DR",
"city": "NORWELL",
"state": "MA",
"postal_code": "020611683",
"telephone_number": "781-878-5200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEAN",
"first_name": "RANDY",
"middle_name": "ALEX",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-22",
"last_updated": "2021-01-22",
"certification_date": "2021-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "20197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwell, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.