Active NPI
Wallace Leo Frigon Jr.
- Physical Therapist
- East Bridgewater, MA
National Provider Identifier
1891344354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 24536
- Practice address
- 650 Plymouth St Ste 9
East Bridgewater, MA 02333-2054 - Phone
- (508) 378-4035
- NPI assigned
- Sep 8, 2019
- 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 | 24536 | MA | Primary |
Addresses
Primary practice location
650 Plymouth St Ste 9
East Bridgewater, MA 02333-2054
Mailing address
1080 Oakhill Ave
Attleboro, MA 02703-7319
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 |
|---|---|---|---|
| 24536 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640908800000",
"number": "1891344354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1080 OAKHILL AVE",
"city": "ATTLEBORO",
"state": "MA",
"postal_code": "027037319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 PLYMOUTH ST STE 9",
"city": "EAST BRIDGEWATER",
"state": "MA",
"postal_code": "023332054",
"telephone_number": "508-378-4035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIGON",
"first_name": "WALLACE",
"middle_name": "LEO",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-08",
"last_updated": "2021-12-31",
"certification_date": "2021-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "24536",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Bridgewater, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.