Individual provider Active NPI

Jay H Bollinger, PT

  • Physical Therapist
  • Mechanicsburg, PA
National Provider Identifier
1124080510
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT016569 Issued in PA
Practice address
21 Waterford Dr
Mechanicsburg, PA 17050-8268
Phone
(717) 620-7100
Fax
(717) 620-7102
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 PT016569 PA Primary

Addresses

Primary practice location

21 Waterford Dr
Mechanicsburg, PA 17050-8268

Mailing address

696 Walborn LN
Apt #8
Millersburg, PA 17061-1176
Phone (717) 692-4047

Other practice location 1

3399 Trindle Rd
Floor 2
Camp Hill, PA 17011-4413
Phone (717) 920-2620

Other identifiers 1

IdentifierTypeStateIssuer
101185252 0001MedicaidPA

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Inspired Physical Therapy Linglestown LLC Physical Therapist PastSince Sep 10, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124080510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 WALBORN LN",
            "address_2": "APT #8",
            "city": "MILLERSBURG",
            "state": "PA",
            "postal_code": "170611176",
            "telephone_number": "717-692-4047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WATERFORD DR",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170508268",
            "telephone_number": "717-620-7100",
            "fax_number": "717-620-7102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3399 Trindle Rd",
            "address_2": "Floor 2",
            "address_purpose": "LOCATION",
            "city": "Camp Hill",
            "state": "PA",
            "postal_code": "170114413",
            "country_code": "US",
            "telephone_number": "717-920-2620",
            "fax_number": "717-920-2621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLLINGER",
        "first_name": "JAY",
        "middle_name": "H",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT016569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101185252 0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.