Active NPI
Nathan Dallas Pavao
- Physical Therapy Assistant
- Taunton, MA
National Provider Identifier
1992228068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 9209
- Practice address
- 68 Dean St
Taunton, MA 02780-2713 - Phone
- (508) 824-2865
- NPI assigned
- Jul 20, 2017
- Sex
- Male
- 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 | 9209 | MA | Primary |
Addresses
Primary practice location
68 Dean St
Taunton, MA 02780-2713
Mailing address
7 Tripp St
Dartmouth, MA 02748-2733
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 |
|---|---|---|---|
| 9209 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1500508800000",
"number": "1992228068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 TRIPP ST",
"city": "DARTMOUTH",
"state": "MA",
"postal_code": "027482733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "68 DEAN ST",
"city": "TAUNTON",
"state": "MA",
"postal_code": "027802713",
"telephone_number": "508-824-2865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVAO",
"first_name": "NATHAN",
"middle_name": "DALLAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-20",
"last_updated": "2017-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MA",
"license": "9209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taunton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.