Organization Active NPI

Patriot All Pro Physical Therapy Centers

  • Specialist
  • Brockton, MA
National Provider Identifier
1841348505
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
229 Issued in MA
Legal business name
PATRIOT ALL PRO PHYSICAL THERAPY CENTERS
Practice address
348 N Pearl St
Brockton, MA 02301-1197
Phone
(508) 897-0056
Fax
(508) 584-5630
NPI assigned
Jan 8, 2007
Last updated
May 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Authorized official

Name
Mrs. Rhonda P. Tippett
Title
Vice President
Phone
(508) 897-0056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 229 MA Primary

Addresses

Primary practice location

348 N Pearl St
Brockton, MA 02301-1197

Mailing address

348 N Pearl St
Brockton, MA 02301-1197
Phone (508) 897-0056

Other identifiers 8

IdentifierTypeStateIssuer
9720430OtherMAMASS HEALTH
0033304OtherMANEIGHBORHOOD HEALTH PLAN
695105OtherMATUFTS HEALTH PLAN
24063OtherMABMC HEALTH NET
9720430MedicaidMA
626334OtherMAHARVARD PILGRIM HEALTHCARE
Y61278OtherMABLUE CROSS BLUE SHIELD OF MA
968175OtherMANETWORK HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051103000432 MA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1759285125 Receives reassigned benefits from 1 practitioner
Practice locations: Brockton, MA; Framingham, MA

National Provider Directory

National Provider Directory

Locations

165 Westgate Dr
Brockton, MA 02301
Phone (508) 583-5800

1460 Dorchester Ave
Dorchester, MA 02122
Phone (617) 282-8700

490 Union Ave
Framingham, MA 01702
Phone (508) 620-0056

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1841348505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 N PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011197",
            "telephone_number": "508-897-0056",
            "fax_number": "508-584-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 N PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011197",
            "telephone_number": "508-897-0056",
            "fax_number": "508-584-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRIOT ALL PRO PHYSICAL THERAPY CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "TIPPETT",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "508-897-0056",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASS HEALTH",
            "identifier": "9720430",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0033304",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "695105",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTH NET",
            "identifier": "24063",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9720430",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCARE",
            "identifier": "626334",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MA",
            "identifier": "Y61278",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "968175",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.