Active NPI
Thilak Purushothaman, PT
- Physical Therapist
- Wilmington, DE
National Provider Identifier
1184189151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- J1-0002405
- Practice address
- 5651 Limestone Rd
Wilmington, DE 19808-1217 - Phone
- (302) 239-8583
- NPI assigned
- Feb 4, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | J1-0002405 | DE | Primary |
Addresses
Primary practice location
5651 Limestone Rd
Wilmington, DE 19808-1217
Mailing address
57 Glencoe Dr
Newark, DE 19702-2056
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
| License | State | Type | Specialty |
|---|---|---|---|
| J1-0002405 | DE | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549238400000",
"number": "1184189151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 GLENCOE DR",
"city": "NEWARK",
"state": "DE",
"postal_code": "197022056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5651 LIMESTONE RD",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198081217",
"telephone_number": "302-239-8583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURUSHOTHAMAN",
"first_name": "THILAK",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-04",
"last_updated": "2019-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "DE",
"license": "J1-0002405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.