Theresa McDonough

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

225200000X Issued in MA

Practice address

1 Market St Ste 3
Lynn, MA 01901-1044

Phone

(781) 592-0540

NPI assigned

Jul 31, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Advance Physical Therapy & Sport Rehab

  • Point of Service
  • Lynn, MA
  • NPI 1417163817
  NPD (past)

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503532800000",
    "number": "1902320179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MOUNT VERNON ST STE 13",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011402",
            "telephone_number": "781-910-9682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MARKET ST STE 3",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011044",
            "telephone_number": "781-592-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONOUGH",
        "first_name": "THERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2017-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "225200000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristian Frederick McCoy, DC
• Elyse Taylor McCue
• Courtney McCusker
• Jessie Danielle McDaid
• Sean McDonough, MA
• Edward McElmon
• Madeleine McElroy
• Laura Marcela McGaughey
• Tiffany McGlowan, MA
• Jennifer J McGovern

• Physical Therapy Assistant in Lynn, MA
• Providers in Lynn, MA by specialty
• Physical Therapy Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.