Individual provider Active NPI

James Robert Perrone, PTA

  • Physical Therapy Assistant
  • Park City, UT
National Provider Identifier
1003050469
Registry record updated Apr 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
P160040882W Issued in WA
Practice address
1640 Redstone Ctr Dr
Suite 200
Park City, UT 84098-7605
Phone
(435) 645-0788
NPI assigned
Apr 28, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X P160040882W WA Primary

Addresses

Primary practice location

1640 Redstone Ctr Dr
Suite 200
Park City, UT 84098-7605

Mailing address

1640 Redstone Ctr Dr
Suite 200
Park City, UT 84098-7605
Phone (435) 645-0788

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

LicenseStateTypeSpecialty
P160040882WWAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jasima Reynolds Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240876800000",
    "number": "1003050469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 REDSTONE CTR DR",
            "address_2": "SUITE 200",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840987605",
            "telephone_number": "435-645-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 REDSTONE CTR DR",
            "address_2": "SUITE 200",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840987605",
            "telephone_number": "435-645-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRONE",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-28",
        "last_updated": "2009-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160040882W",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.