Prestige Physical Therapy, L.L.C.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

40QA00966100 Issued in NJ

Legal business name

PRESTIGE PHYSICAL THERAPY, L.L.C.

Practice address

463 Livingston St
Suite 203
Norwood, NJ 07648-1344

Phone

(201) 921-7766

NPI assigned

Mar 22, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Keith Allen Rogers, P.T.NPI 1174678452

Title

Owner

Phone

(201) 921-7766

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keith Allen Rogers, P.T.

  • Physical Therapist
  • Oakland, NJ
  • NPI 1174678452
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296432000000",
    "number": "1003932880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 MANITO AVE",
            "city": "OAKLAND",
            "state": "NJ",
            "postal_code": "074364013",
            "telephone_number": "201-921-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 LIVINGSTON ST",
            "address_2": "SUITE 203",
            "city": "NORWOOD",
            "state": "NJ",
            "postal_code": "076481344",
            "telephone_number": "201-921-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE PHYSICAL THERAPY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2011-01-31",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-921-7766",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NJ",
            "license": "40QA00966100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Samantha Female Ripps-Palacios

• Physical Therapy Clinic/Center in Norwood, NJ
• Providers in Norwood, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.