OrganizationActive
Impact Sports Lab
NPI 1922857432 · Health Service Clinic/Center · Woburn, MA
Provider details
- NPI number
- 1922857432
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Ian Carrera, Owner(617) 549-6296
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(56/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
220 W Cummings Park
Woburn, MA 01801-6346
Phone: (617) 549-6296
Approximate (ZIP-level) locationGet directions
Mailing address
220 W Cummings Park
Woburn, MA 01801-6346
Registry dates
- Enumerated
- 2024-05-16
- Last updated
- 2024-05-16
- Certified
- 2024-05-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.