Individual provider Active NPI

Debra Pronzato, MS, PT

  • Physical Therapist
  • Kennett Square, PA
National Provider Identifier
1053436980
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT005416-L Issued in PA
Practice address
600 S Broad St
Kennett Square, PA 19348-3346
Phone
(800) 992-9711
Fax
(610) 925-4579
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT005416-L PA Primary

Addresses

Primary practice location

600 S Broad St
Kennett Square, PA 19348-3346

Mailing address

12 Overlook Ave
Willow Grove, PA 19090-2722
Phone (215) 659-4174

Other names 1

  • Debra Hodge Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PT005416-LPAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053436980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 OVERLOOK AVE",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190902722",
            "telephone_number": "215-659-4174",
            "fax_number": "215-658-0215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S BROAD ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483346",
            "telephone_number": "800-992-9711",
            "fax_number": "610-925-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRONZATO",
        "first_name": "DEBRA",
        "credential": "MS, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT005416-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "HODGE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kennett Square, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.