Individual provider Active NPI

Melissa Lynn Clugston, PTA

  • Physical Therapy Assistant
  • Wyncote, PA
National Provider Identifier
1154030823
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
8100 Washington LN
Wyncote, PA 19095-1600
Phone
(215) 576-8000
NPI assigned
Nov 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 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 Therapy Assistant 225200000X Primary

Addresses

Primary practice location

8100 Washington LN
Wyncote, PA 19095-1600

Mailing address

7337 Valley Ave
Philadelphia, PA 19128-3223
Phone (215) 876-7930

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

NPI Registry JSON

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1154030823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7337 VALLEY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191283223",
            "telephone_number": "215-876-7930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 WASHINGTON LN",
            "city": "WYNCOTE",
            "state": "PA",
            "postal_code": "190951600",
            "telephone_number": "215-576-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLUGSTON",
        "first_name": "MELISSA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-21",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyncote, PA

Sources for this page

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