Organization Active NPI

Ray Derek Munn

  • Physical Therapist
  • Newton, MA
National Provider Identifier
1912070301
Registry record updated Oct 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11262 Issued in MA
Legal business name
RAY DEREK MUNN
Doing business as
At Home Physical Therapy
Practice address
30 Playstead Rd
Suite #1
Newton, MA 02458-2125
Phone
(617) 306-6519
Fax
(617) 244-4672
NPI assigned
Nov 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2008

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

Authorized official

Name
Ray Derek Munn, PT, MPT, DPT, OCS
Title
Owner
Phone
(617) 306-6519

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 11262 MA Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

30 Playstead Rd
Suite #1
Newton, MA 02458-2125

Mailing address

30 Playstead Rd
Suite #1
Newton, MA 02458-2125
Phone (617) 306-6519

Other identifiers 1

IdentifierTypeStateIssuer
PT0329OtherMEDICARE IDENTIFICATION NUMBER

Other names 1

  • At Home Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222992000000",
    "number": "1912070301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PLAYSTEAD RD",
            "address_2": "SUITE #1",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024582125",
            "telephone_number": "617-306-6519",
            "fax_number": "617-244-4672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PLAYSTEAD RD",
            "address_2": "SUITE #1",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024582125",
            "telephone_number": "617-306-6519",
            "fax_number": "617-244-4672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAY DEREK MUNN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2008-10-03",
        "status": "A",
        "authorized_official_last_name": "MUNN",
        "authorized_official_first_name": "RAY",
        "authorized_official_middle_name": "DEREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-306-6519",
        "authorized_official_credential": "PT, MPT, DPT, OCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "11262",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE IDENTIFICATION NUMBER",
            "identifier": "PT0329",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "At Home Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 3, 2008; 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.