Individual provider Active NPI

Bethany Sturgis, PTA

  • Physical Therapy Assistant
  • Kingston, MA
National Provider Identifier
1972157063
Registry record updated Jul 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
9615 Issued in MA
Practice address
17 Chipman Way
Kingston, MA 02364-1039
Phone
(781) 585-4100
NPI assigned
Jul 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TEI005472 PA
Physical Therapy Assistant 225200000X 9615 MA Primary

Addresses

Primary practice location

17 Chipman Way
Kingston, MA 02364-1039

Mailing address

4 Hawthorn Rd
Milton, MA 02186-1612
Phone (570) 371-7397

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9615MAMDPsychologist
TEI005472PAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1564272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564272000000",
    "number": "1972157063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HAWTHORN RD",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021861612",
            "telephone_number": "570-371-7397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 CHIPMAN WAY",
            "city": "KINGSTON",
            "state": "MA",
            "postal_code": "023641039",
            "telephone_number": "781-585-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURGIS",
        "first_name": "BETHANY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-28",
        "last_updated": "2019-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TEI005472",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "9615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2019; 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.