Jelkam Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

0218591 Issued in NY

Legal business name

JELKAM PHYSICAL THERAPY

Practice address

24 Oakridge Dr
Binghamton, NY 13903-2125

Phone

(607) 349-8534

NPI assigned

Jun 17, 2014

Last updated

Nov 12, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Randall Fardale Wimberly, MSPT

Title

Owner/ Ceo

Phone

(607) 349-8534

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447286400000",
    "number": "1114331212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 OAKRIDGE DR",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139032125",
            "telephone_number": "607-349-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 OAKRIDGE DR",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139032125",
            "telephone_number": "607-349-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JELKAM PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-17",
        "last_updated": "2015-11-12",
        "status": "A",
        "authorized_official_last_name": "WIMBERLY",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "FARDALE",
        "authorized_official_title_or_position": "OWNER/ CEO",
        "authorized_official_telephone_number": "607-349-8534",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "0218591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monet Jarvis
• Huzaifa Javaid
• Toseef Javaid, M.D.
• Megan Elizabeth Jaworski, PTA
• Venkatesh Babu Jayaraman, MD
• Jima Jenab, MD
• Cynthia Jenkins, CASAC T
• Jeffrey Jenkins, RN BSN
• Anita Jensen, RN
• Jerome C Cohen, MD, PC

• Physical Therapy Clinic/Center in Binghamton, NY
• Providers in Binghamton, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.