Individual provider Active NPI

Donna Marie Cullen, PTA

  • Physical Therapy Assistant
  • Weatherly, PA
National Provider Identifier
1073852711
Registry record updated Jan 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
TEI000739 Issued in PA
Practice address
525 Round Head Dr
Weatherly, PA 18255-3721
Phone
(570) 427-4340
NPI assigned
Jan 31, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2013

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 TEI000739 PA Primary

Addresses

Primary practice location

525 Round Head Dr
Weatherly, PA 18255-3721

Mailing address

525 Round Head Dr
Weatherly, PA 18255-3721
Phone (570) 427-4340

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
TEI000739PAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1359590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1073852711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 ROUND HEAD DR",
            "city": "WEATHERLY",
            "state": "PA",
            "postal_code": "182553721",
            "telephone_number": "570-427-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 ROUND HEAD DR",
            "city": "WEATHERLY",
            "state": "PA",
            "postal_code": "182553721",
            "telephone_number": "570-427-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLEN",
        "first_name": "DONNA",
        "middle_name": "MARIE",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-31",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TEI000739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weatherly, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; 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.