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
- Last updated
- 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 | Dentist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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.