Active NPI
Carol Correa Tan, PT
- Physical Therapist
- Morristown, NJ
National Provider Identifier
1053640359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT40QA01314300
- Practice address
- 802 Lindsley Dr
Apt 2B
Morristown, NJ 07960-4495 - Phone
- (816) 225-7936
- NPI assigned
- Dec 15, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT40QA01314300 | NJ | Primary |
Addresses
Primary practice location
802 Lindsley Dr
Apt 2B
Morristown, NJ 07960-4495
Mailing address
802 Lindsley Dr
Apt 2B
Morristown, NJ 07960-4495
Phone (816) 225-7936
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT40QA01314300 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260835200000",
"number": "1053640359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 LINDSLEY DR",
"address_2": "APT 2B",
"city": "MORRISTOWN",
"state": "NJ",
"postal_code": "079604495",
"telephone_number": "816-225-7936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "802 LINDSLEY DR",
"address_2": "APT 2B",
"city": "MORRISTOWN",
"state": "NJ",
"postal_code": "079604495",
"telephone_number": "816-225-7936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "CAROL",
"middle_name": "CORREA",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-12-15",
"last_updated": "2009-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "PT40QA01314300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morristown, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.