Individual provider Active NPI

Tammy G. Pantle, PT

  • Physical Therapist
  • Elmira, NY
National Provider Identifier
1174686786
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
012302-1 Issued in NY
Practice address
555 E Market St
Elmira, NY 14901-3223
Phone
(607) 733-6541
Fax
(607) 737-1532
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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 012302-1 NY Primary

Addresses

Primary practice location

555 E Market St
Elmira, NY 14901-3223

Mailing address

150 Broad St
Waverly, NY 14892-1361
Phone (607) 687-2495

Other names 1

  • Tammy G. Roach Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Tammy.pantle@direct-guthrie.org

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
012302-1NYMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: tammy.pantle@direct-guthrie.org

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1174686786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 BROAD ST",
            "city": "WAVERLY",
            "state": "NY",
            "postal_code": "148921361",
            "telephone_number": "607-687-2495",
            "fax_number": "607-565-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E MARKET ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013223",
            "telephone_number": "607-733-6541",
            "fax_number": "607-737-1532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTLE",
        "first_name": "TAMMY",
        "middle_name": "G.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "012302-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Tammy.pantle@direct-guthrie.org",
            "affiliation": "N",
            "endpointDescription": "Direct",
            "address_1": "150 Broad St",
            "city": "Waverly",
            "state": "NY",
            "country_code": "US",
            "postal_code": "148921361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TAMMY",
            "last_name": "ROACH",
            "middle_name": "G.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elmira, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.