DR. IVY LYNN BRACKUP (NPI# 1184691891) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184691891 |
| Entity Type | Individual |
| Full Name | DR. IVY LYNN BRACKUP |
| Credential | MD |
| Practice Address |
372 Washington St. Marino Center for Integrative Health Wellesley MA 02481 |
| Practice Telephone | 7812355200 |
| Practice Fax Number | 6173821101 |
| Mailing Telephone | 7812355200 |
| Mailing Fax Number | 6173821101 |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2011-09-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171W00000X | Contractor | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 3177190 | 05 |
| Street Address |
372 WASHINGTON ST. MARINO CENTER FOR INTEGRATIVE HEALTH |
| City | WELLESLEY |
| State | MA |
| Zip Code | 02481 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699329797 | Jeffrey A. Harrison, Dmd, PC | Dentist | 258 Washington Street, Wellesley, MA 02481 | 2019-07-26 |
| 1922651215 | Steffanie Accorsi | Behavior Technician | 110 Cedar St, Suite 10, Wellesley, MA 02481 | 2019-07-17 |
| 1023673977 | Alka Swarup | Occupational Therapist | 10 Hunnewell Street, Wellesley Hls, MA 02481 | 2019-05-07 |
| 1740779511 | Marianne Brandon | Psychologist | Marianne Brandon Phd, 25 Walnut St #202, Wellesley Hills, MA 02481 | 2018-05-07 |
| 1558722686 | Robin Cook-nobles | Psychologist | 106 Central Street, The Stone Center Wellesley College, Wellesley, MA 02481 | 2016-03-17 |
| 1851760169 | Samantha Eve Jordan | Student in an Organized Health Care Education/Training Program | 30 Washington Street Suite 300, Wellesley, MA 02481 | 2015-09-16 |
| 1942677224 | Sandra Schwartz | Physical Therapist | Summit Orthopedic Therapy, 40 Washington Street, Wellesly, MA 02481 | 2015-08-21 |
| 1053710467 | Train Boston Physical Therapy, Inc. | Exclusive Provider Organization | 34 Washington Street, Wellesley, MA 02481 | 2014-08-21 |
| 1124458344 | Allison Arrigg | Counselor | 11 Chapel Place, Human Relations Service, Wellesley Hills, MA 02481 | 2013-11-25 |
| 1932531472 | Abigail Gorman Daunis | Physical Therapist | 34 Washington St., Wellesley, MA 02481 | 2013-08-07 |
| Find all providers in zip 02481 | ||||
| Taxonomy Code | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487079638 | Victoria Hicks | Contractor | 40 Washington St, Suite 240, Wellesley, MA 02481-1805 | 2014-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558586 | Kimberley S Paris | Contractor | 800 W Cummings Park Ste 5225, Woburn, MA 01801-6356 | 2020-11-05 |
| 1386206084 | Jerome Currier | Contractor | 293 Exchange St, Athol, MA 01331-1843 | 2019-07-02 |
| 1992207849 | Robelou Medical Collections Ect | Contractor | 202 Bussey St, Dedham, MA 02026-2512 | 2018-03-07 |
| 1508374075 | Unique's Hopes and Dreams | Contractor | 110 Haverhill Rd Ste 331, Amesbury, MA 01913-2146 | 2018-01-17 |
| 1063958908 | Sangrine James | Contractor | 35 Orchardfield St, Dorchester, MA 02122-2806 | 2017-01-17 |
| 1356794390 | Taryn Bausch | Contractor | 785 Williams St # 198, Longmeadow, MA 01106-2063 | 2016-07-14 |
| 1346690328 | Kathleen Ricci | Contractor | 118 Coolidge St, Brookline, MA 02446-5808 | 2016-06-21 |
| 1588027544 | Michelle Teachout | Contractor | 7 Fosters Pt, Beverly, MA 01915-3911 | 2016-03-29 |
| 1336514231 | Richard Frisch | Contractor | 92 Groton Rd, Shirley, MA 01464-2313 | 2015-12-03 |
| 1184095804 | Stacey Robinson | Contractor | 17 Foster St Unit 13, Brockton, MA 02301-5974 | 2015-10-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.