Individual provider Active NPI

Joan Durkin-Klein, PTA

  • Physical Therapy Assistant
  • Philadelphia, PA
National Provider Identifier
1053784579
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
40QB00100100 Issued in NJ
Practice address
14500 Bustleton Ave
Suite 1a
Philadelphia, PA 19116-1188
Phone
(215) 613-6523
Fax
(215) 613-6527
NPI assigned
Nov 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 40QB00100100 NJ Primary

Addresses

Primary practice location

14500 Bustleton Ave
Suite 1a
Philadelphia, PA 19116-1188

Mailing address

527 Wrightstown Sykesville Rd
Building C, Unit 15
Wrightstown, NJ 08562-1530
Phone (609) 316-0195

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

LicenseStateTypeSpecialty
40QB00100100NJMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1053784579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 WRIGHTSTOWN SYKESVILLE RD",
            "address_2": "BUILDING C, UNIT 15",
            "city": "WRIGHTSTOWN",
            "state": "NJ",
            "postal_code": "085621530",
            "telephone_number": "609-316-0195",
            "fax_number": "609-353-1549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14500 BUSTLETON AVE",
            "address_2": "SUITE 1A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191161188",
            "telephone_number": "215-613-6523",
            "fax_number": "215-613-6527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURKIN-KLEIN",
        "first_name": "JOAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-05",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00100100",
            "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 5, 2015; 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.