Active NPI
Susan Amanda Murray-Blake, PT, RMT
- Physical Therapist
- Charlton, MA
National Provider Identifier
1982138418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 17540
- Practice address
- 19 Prince Rd
Charlton, MA 01507-5117 - Phone
- (774) 402-0552
- NPI assigned
- Apr 11, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 17540 | MA | Primary |
Addresses
Primary practice location
19 Prince Rd
Charlton, MA 01507-5117
Mailing address
19 Prince Rd
Charlton, MA 01507-5117
Phone (774) 402-0552
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17540 | MA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SMB Therapy | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapy Clinic/Center
- Charlton, MA
- NPI 1952835480
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491868800000",
"number": "1982138418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 PRINCE RD",
"city": "CHARLTON",
"state": "MA",
"postal_code": "015075117",
"telephone_number": "774-402-0552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 PRINCE RD",
"city": "CHARLTON",
"state": "MA",
"postal_code": "015075117",
"telephone_number": "774-402-0552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MURRAY-BLAKE",
"first_name": "SUSAN",
"middle_name": "AMANDA",
"credential": "PT, RMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-11",
"last_updated": "2017-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "17540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.