Active NPI
Gina Vitale, PTA
- Physical Therapy Assistant
- Beverly, MA
National Provider Identifier
1982169041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 7703
- Practice address
- 100 Cummings Ctr Ste 166D
Beverly, MA 01915-6135 - Phone
- (978) 712-3370
- Fax
- (978) 922-4416
- NPI assigned
- Feb 4, 2019
- Sex
- Female
- Sole proprietor
- No
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 Therapy Assistant | 225200000X | 7703 | MA | Primary |
Addresses
Primary practice location
100 Cummings Ctr Ste 166D
Beverly, MA 01915-6135
Mailing address
100 Cummings Center
166 D
Beverly, MA 01915
Phone (978) 712-3370
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 |
|---|---|---|---|
| 7703 | MA | MD | Clinical Neuropsychologist |
Interoperability endpoints
- gina.vitale.p1@direct.elementcare.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549238400000",
"number": "1982169041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 CUMMINGS CENTER",
"address_2": "166 D",
"city": "BEVERLY",
"state": "MA",
"postal_code": "01915",
"telephone_number": "978-712-3370",
"fax_number": "978-922-4416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CUMMINGS CTR STE 166D",
"city": "BEVERLY",
"state": "MA",
"postal_code": "019156135",
"telephone_number": "978-712-3370",
"fax_number": "978-922-4416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VITALE",
"first_name": "GINA",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-04",
"last_updated": "2019-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MA",
"license": "7703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beverly, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.