Paulette E Jackman

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

TEI005377 Issued in PA

Practice address

1410 Manoa Rd
Wynnewood, PA 19096-3208

Phone

(610) 896-9000

NPI assigned

Nov 9, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Anthony Marziano Jr BSC MPT PC

  • Physical Therapist
  • Wynnewood, PA
  • NPI 1437156817
  NPD

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1023610680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 MANOA RD",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 MANOA RD",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963208",
            "telephone_number": "610-896-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKMAN",
        "first_name": "PAULETTE",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TEI005377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ptplus@gmail.com",
            "affiliation": "N",
            "address_1": "1410 Manoa Rd",
            "city": "Wynnewood",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190963208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Integrated Foot and Ankle Specialists of PA LLC
• Ali Iqbal, MD
• Isadore P Forman DPM LTD
• Alice May Isidro, PA-C
• Filip Istvanic, MD
• Olivia Kate Jacques, MD
• Deeksha Jain, PA-C
• Gaurav Jain, M.D.
• Aria Jalalian
• James a Morris MD LLC

• Physical Therapy Assistant in Wynnewood, PA
• Providers in Wynnewood, PA by specialty
• Physical Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.