Individual provider Active NPI

Edward Haughey, PT

  • Physical Therapist
  • Broomall, PA
National Provider Identifier
1164107157
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT013845L Issued in PA
Practice address
2004 Sproul Rd FL 1
Broomall, PA 19008-3511
Phone
(610) 359-1580
Fax
(833) 941-3871
NPI assigned
Jun 19, 2023
Last updated
Apr 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Physical Therapist 225100000X PT013845L PA Primary

Addresses

Primary practice location

2004 Sproul Rd FL 1
Broomall, PA 19008-3511

Mailing address

PO Box 34990
Belfast, ME 04915-0627
Phone (610) 359-5640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040616000586 PA Practitioner - Physical Therapist in Private Practice 7618951716 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT013845LPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Orthopaedic and Sports Medicine Associates, LTD Physical Therapist CurrentSince Apr 17, 2025 Accepting new patients
Premier Orthopaedic and Sports Medicine Associates LTD Physical Therapist CurrentSince Apr 17, 2025 Accepting new patients
Restorative Therapies, Inc. Physical Therapist Past Accepting new patients

Locations

2004 Sproul Rd
Fl 1
Broomall, PA 19008
Phone (610) 353-0800

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1164107157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34990",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049150627",
            "telephone_number": "610-359-5640",
            "fax_number": "833-941-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 SPROUL RD FL 1",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083511",
            "telephone_number": "610-359-1580",
            "fax_number": "833-941-3871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGHEY",
        "first_name": "EDWARD",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-19",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT013845L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomall, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.