Individual provider Active NPI

Nancy Larralde, PT

  • Physical Therapist
  • Pittston, PA
National Provider Identifier
1164767851
Registry record updated Dec 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT005628L Issued in PA
Practice address
209 Roberts Road
United Methodist Home Wesley Village
Pittston, PA 18640
Phone
(570) 655-2891
NPI assigned
Dec 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2012

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 PT005628L PA Primary

Addresses

Primary practice location

209 Roberts Road
United Methodist Home Wesley Village
Pittston, PA 18640

Mailing address

338 Joseph Dr
Kingston, PA 18704-5634
Phone (570) 714-3049

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
PT005628LPAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354752000000",
    "number": "1164767851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 JOSEPH DR",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045634",
            "telephone_number": "570-714-3049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 ROBERTS ROAD",
            "address_2": "UNITED METHODIST HOME WESLEY VILLAGE",
            "city": "PITTSTON",
            "state": "PA",
            "postal_code": "18640",
            "telephone_number": "570-655-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARRALDE",
        "first_name": "NANCY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-06",
        "last_updated": "2012-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT005628L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittston, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; 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.