SPORTS MEDICINE NORTH ORTHOPAEDIC SURGERY, INC. (NPI# 1861837015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861837015 |
| Entity Type | Organization |
| Organization Name | SPORTS MEDICINE NORTH ORTHOPAEDIC SURGERY, INC. |
| Other Organization Name | PHYSICAL THERAPY NORTH |
| Practice Address |
2 1st Ave Suite 211 Peabody MA 01960-4959 |
| Mailing Address |
1 Orthopedics Dr 2nd Floor Peabody MA 01960-1668 |
| Practice Telephone | 9785351213 |
| Mailing Telephone | 9788186350 |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2016-07-25 |
| Authorized Official Name | DR. JEFFREY POLANSKY (PRESIDENT) |
| Authorized Official Telephone | 9788186350 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | MEDICARE | M15814 | 01 |
| MA | 9773363 | 05 |
| Other Name | Type Code |
|---|---|
| Physical Therapy North | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376077552 | Sports Medicine North Orthopaedic Surgery, Inc. | Specialist | 30 Tozer Rd, Beverly, MA 01915-5510 | 2017-04-14 |
| 1437380698 | Sports Medicine North Orthopaedic Surgery, Inc. | Specialist | 1 Wallace Bashaw Jr. Way, Newburyport, MA 01950 | 2009-08-05 |
| 1699171470 | Sports Medicine North Orthopaedic Surgery, Inc. | Specialist | 1 Orthopedics Dr, Peabody, MA 01960-1668 | 2014-11-06 |
| 1760423719 | Sports Medicine North Orthopaedic Surgery, Inc. | Specialist | 1 Orthopedic Dr, 2nd Floor, Peabody, MA 01960-1668 | 2006-06-09 |
| Street Address |
2 1ST AVE SUITE 211 |
| City | PEABODY |
| State | MA |
| Zip Code | 01960-4959 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396747192 | Jennifer D. Goldman | Pharmacist | 2 1st Ave, Well Life, Peabody, MA 01960-4959 | 2005-08-11 |
| 1033688031 | Cynthia Marie Navarro | Licensed Practical Nurse | 2 1st Ave, Peabody, MA 01960-4959 | 2018-11-19 |
| 1215455456 | Tatum Fahs | Occupational Therapist | 2 1st Ave, Peabody, MA 01960 | 2017-09-08 |
| 1235489121 | Kristen Ann Upham | Nurse Practitioner | 2 1st Ave, Suite 215, Peabody, MA 01960 | 2012-09-18 |
| 1669596946 | Kristen Lyn Harte | Nurse Practitioner | 2 1st Ave, Suite 215, Peabody, MA 01960-4959 | 2007-03-19 |
| 1992881643 | Francis Michael Harte | Internal Medicine | 2 1st Ave, Suite 215, Peabody, MA 01960-4909 | 2006-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962020321 | Kathleen Marie Cliffe | Nurse Practitioner | 15 Sandra Rd, Peabody, MA 01960 | 2020-07-10 |
| 1801398102 | Janis Melanson | Counselor | Higgins Middle School, 85 Perkins Street, Peabody, MA 01960 | 2018-03-02 |
| 1679082036 | Kelsey Ann Lima | Social Worker | 9 Centennial Drive, Suite 202, Peabody, MA 01960 | 2017-09-28 |
| 1609394485 | Victoria Jade Olechowski | Specialist/Technologist | 1002 Crane Brook Way, Peabody, MA 01960 | 2017-08-31 |
| 1841715711 | Alexandra Lee Chasse | Counselor | 9 Cenntenial Drive, Suit 202, Peabody, MA 01960 | 2017-08-11 |
| 1275982936 | Miguel A Roque | Dentist | 6 Essex Center Drive Suite 110, Peabody, MA 01960 | 2016-06-03 |
| 1528412061 | Kabamedicalcorporation | Durable Medical Equipment & Medical Supplies | 484lowell Street, Peabody, MA 01960 | 2016-04-21 |
| 1437510815 | Ana Tereza T. Wescott | Dentist | 89 Foster Street, Peabody Family Health Center, Peabody, MA 01960 | 2016-03-14 |
| 1225496474 | Ashley Motta | Counselor | 24 Jennifer Lane, Peabody, MA 01960 | 2016-02-03 |
| 1578942645 | Cerebral Palsy of Eastern Mass Incorporated | Early Intervention Provider Agency | 6 Stratis Way, Peabody, MA 01960 | 2015-05-22 |
| Find all providers in zip 01960 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942659198 | Sports Medicine North | Physical Therapist | 2 First Ave Suite 211, Peabody, MA 01960-4959 | 2016-06-08 |
| 1972596054 | Barbara E. Dinenno | Physical Therapist | 2 Essex Center Dr, Peabody, MA 01960-2902 | 2005-08-24 |
| 1376536680 | Gregory Francis Surman | Physical Therapist | 100 Corporate Pl, Suite 103, Peabody, MA 01960-3865 | 2005-08-23 |
| 1861599136 | Thomas R Cookson Inc | Physical Therapist | 100 Corporate Pl, Suite 103, Peabody, MA 01960-3865 | 2006-09-20 |
| 1417963513 | Sarah Jane Cosme-torabi | Physical Therapist | 1 Orthopedics Dr, Peabody, MA 01960-1668 | 2006-07-31 |
| 1891762241 | Megan E. Despres | Physical Therapist | 1 Orthopedic Dr, Lower Level, Peabody, MA 01960-1668 | 2006-03-03 |
| 1831182716 | Michelle Cullinane | Physical Therapist | 100 Corporate Pl, Suite 103, Peabody, MA 01960-3865 | 2005-08-25 |
| 1023001344 | Thomas Russell Cookson | Physical Therapist | 100 Corporate Pl, Suite 103, Peabody, MA 01960-3865 | 2005-08-23 |
| 1376536698 | Rena Dierdre Walsh-noring | Physical Therapist | 100 Corporate Pl, Suite 103, Peabody, MA 01960-3865 | 2005-08-23 |
| 1255324570 | Susan Koenig | Physical Therapist | 100 Corporate Pl, Suite 103, Peabody, MA 01960-3865 | 2005-08-23 |
| Find all providers in PEABODY | ||||
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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.