NPIMap

Organization Active NPI

Pennsport Physical Therapy Inc

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1023018793
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PENNSPORT PHYSICAL THERAPY INC
Practice address
2101 S Columbus Blvd
Philadelphia, PA 19148-2805
Phone
(215) 467-4431
Fax
(215) 467-8879
NPI assigned
Jul 26, 2005
Last updated
Nov 19, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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

Authorized official

Name
Michael A Deluca, PTNPI 1700887429
Title
President
Phone
(215) 467-4431

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

2101 S Columbus Blvd
Philadelphia, PA 19148-2805

Mailing address

2101 S Columbus Blvd
Philadelphia, PA 19148-2805
Phone (215) 467-4431

National Provider Directory

National Provider Directory

Locations

2101 S Delaware Ave
Philadelphia, PA 19148
Phone (215) 467-4431

3310 S 20th St
Philadelphia, PA 19145
Phone (215) 336-4000

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1023018793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 S COLUMBUS BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191482805",
            "telephone_number": "215-467-4431",
            "fax_number": "215-467-8879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 S COLUMBUS BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191482805",
            "telephone_number": "215-467-4431",
            "fax_number": "215-467-8879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNSPORT PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-26",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "DELUCA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-467-4431",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; 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.