Individual provider Active NPI

Timothy Atha

  • Physical Therapy Assistant
  • Owego, NY
National Provider Identifier
1013755487
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
014304 Issued in NY
Practice address
1868 E Beecher Hill Rd
Owego, NY 13827-3815
Phone
(607) 743-5910
NPI assigned
Jul 18, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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 014304 NY Primary

Addresses

Primary practice location

1868 E Beecher Hill Rd
Owego, NY 13827-3815

Mailing address

1868 E Beecher Hill Rd
Owego, NY 13827-3815
Phone (607) 743-5910

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
014304NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1013755487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1868 E BEECHER HILL RD",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "138273815",
            "telephone_number": "607-743-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1868 E BEECHER HILL RD",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "138273815",
            "telephone_number": "607-743-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATHA",
        "first_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "014304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owego, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.