Individual provider Active NPI

Carly Egrie

  • Physical Therapist
  • Ventnor City, NJ
National Provider Identifier
1043970403
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02064500 Issued in NJ
Practice address
6601 Ventnor Ave Ste 105
Ventnor City, NJ 08406-2168
Phone
(609) 350-6680
NPI assigned
Dec 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA02064500 NJ Primary

Addresses

Primary practice location

6601 Ventnor Ave Ste 105
Ventnor City, NJ 08406-2168

Mailing address

175 W Cohawkin Rd Ste C
Clarksboro, NJ 08020-1145
Phone (856) 423-7700

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 6601VentnorAvenue Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220120000876 NJ Practitioner - Physical Therapist in Private Practice 4284026469 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Inc Physical Therapist CurrentSince Apr 1, 2023 Accepting new patients

Locations

872 E Main St
Bridgewater, NJ 08807
Phone (908) 725-2995

407 W Delilah Rd
Pleasantville, NJ 08232
Phone (609) 289-2331

Organizations & group practices 2

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": "1640649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1043970403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 W COHAWKIN RD STE C",
            "city": "CLARKSBORO",
            "state": "NJ",
            "postal_code": "080201145",
            "telephone_number": "856-423-7700",
            "fax_number": "856-423-0823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 VENTNOR AVE STE 105",
            "city": "VENTNOR CITY",
            "state": "NJ",
            "postal_code": "084062168",
            "telephone_number": "609-350-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGRIE",
        "first_name": "CARLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-28",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02064500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "6601VentnorAvenue",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "6601 Ventnor Ave Ste 105",
            "city": "Ventnor City",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "084062168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ventnor City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; 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.