Individual provider Active NPI

Lauren Hennessey, DPT

  • Physical Therapist
  • Canton, MA
National Provider Identifier
1922556364
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22511 Issued in MA
Practice address
100B Washington St
Canton, MA 02021-4000
Phone
(781) 214-6505
Fax
(781) 214-6452
NPI assigned
Sep 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 22511 MA Primary

Addresses

Primary practice location

100B Washington St
Canton, MA 02021-4000

Mailing address

250 E Main St
Norton, MA 02766-2436
Phone (857) 444-0999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161020001263 MA Practitioner - Physical Therapist in Private Practice 0749568053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22511MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts Physical Therapy Services of Quincy Bay, LLC Physical Therapist CurrentSince Jul 15, 2024 Accepting new patients
Marathon Physical Therapy and Sports Medicine, LLC Physical Therapist PastSince Aug 3, 2016 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1922556364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E MAIN ST",
            "city": "NORTON",
            "state": "MA",
            "postal_code": "027662436",
            "telephone_number": "857-444-0999",
            "fax_number": "508-285-4483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100B WASHINGTON ST",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020214000",
            "telephone_number": "781-214-6505",
            "fax_number": "781-214-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSEY",
        "first_name": "LAUREN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "22511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.