Active NPI
Melissa Wade, DPT
- Physical Therapist
- Taunton, MA
National Provider Identifier
1871979005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 21844
- Practice address
- 63 Winthrop St
Unit C1-C2
Taunton, MA 02780-6218 - Phone
- (508) 880-3223
- Fax
- (508) 822-8516
- NPI assigned
- Aug 11, 2015
- Sex
- Female
- 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 | 21844 | MA | Primary |
Addresses
Primary practice location
63 Winthrop St
Unit C1-C2
Taunton, MA 02780-6218
Mailing address
111 Willard St
Suite 2a
Quincy, MA 02169-1200
Phone (617) 471-5053
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 |
|---|---|---|---|
| 21844 | MA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bay State Physical Therapy of Randolph Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Fall River, MA
- NPI 1164474334
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439251200000",
"number": "1871979005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 WILLARD ST",
"address_2": "SUITE 2A",
"city": "QUINCY",
"state": "MA",
"postal_code": "021691200",
"telephone_number": "617-471-5053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "63 WINTHROP ST",
"address_2": "UNIT C1-C2",
"city": "TAUNTON",
"state": "MA",
"postal_code": "027806218",
"telephone_number": "508-880-3223",
"fax_number": "508-822-8516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "MELISSA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-11",
"last_updated": "2015-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "21844",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taunton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.