Active NPI
Keith Alan Wade, MPT
- Physical Therapist
- Newton, MA
National Provider Identifier
1841401528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10836
- Practice address
- 142 Church St
Newton, MA 02458-2004 - Phone
- (617) 244-2608
- NPI assigned
- May 24, 2007
- 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 | 10836 | MA | Primary |
Addresses
Primary practice location
142 Church St
Newton, MA 02458-2004
Mailing address
142 Church St
Newton, MA 02458-2004
Phone (617) 244-2608
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841401528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "142 CHURCH ST",
"city": "NEWTON",
"state": "MA",
"postal_code": "024582004",
"telephone_number": "617-244-2608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "142 CHURCH ST",
"city": "NEWTON",
"state": "MA",
"postal_code": "024582004",
"telephone_number": "617-244-2608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "KEITH",
"middle_name": "ALAN",
"name_prefix": "Mr.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "10836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.