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OLYMPIC PHYSICAL MEDICINE NPI 1255369963


NPI Information

NPI: 1255369963
Provider Name: OLYMPIC PHYSICAL MEDICINE
Classification: Physical Therapist - 2251S0007X
Entity Type: Organization

Specialization: Sports

Address:
200 MAIN STREET
111
STONEHAM, MA
ZIP 02180
Phone: (617) 666-8800
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OLYMPIC PHYSICAL MEDICINE is a sports physical therapist in Stoneham, MA. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Sports Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science, pathology and pathophysiology, medical and surgical intervention, and health and wellness, as well as rehabilitation/return to sports, management of acute injury/illness, medical and surgical consideration, injury prevention, and sports performance enhancement. OLYMPIC PHYSICAL MEDICINE NPI is 1255369963. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

200 MAIN STREET
111
STONEHAM, MA
ZIP 02180-619
Phone: (617) 666-8800
Fax: (617) 666-4488

The provider's authorized official is Douglas E White .
The authorized official title is President and has the following contact phone number (617) 666-8800.

The enumeration date for this NPI number is 6/29/2006 and was last updated on 4/20/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1225100000XPhysical TherapistNo
22251X0800XPhysical TherapistOrthopedicNo
32255A2300XSpecialist/TechnologistAthletic TrainerNo
42251S0007XPhysical TherapistSportsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12752329OTHERMASSACHUSETTSAETNA
2=========OTHERMASSACHUSETTSUNICARE
3AA36064OTHERMASSACHUSETTSHARVARD PILGRIM
4=========OTHERMASSACHUSETTSCIGNA
5=========OTHERMASSACHUSETTSUNITED
60035582OTHERMASSACHUSETTSNEIGHBORHOOD HEALTH
7Y61424OTHERMASSACHUSETTSBC/BS
8PT0294MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.