Individual provider Active NPI

Jacqueline Louise Lamont, PTA

  • Physical Therapy Assistant
  • Johnson City, NY
National Provider Identifier
1205167574
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
X007360-1 Issued in NY
Practice address
18 Broad St.
Johnson City, NY 13790-2198
Phone
(607) 798-7117
Fax
(607) 798-0074
NPI assigned
Jan 26, 2010
Last updated
Jul 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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 X007360-1 NY Primary

Addresses

Primary practice location

18 Broad St.
Johnson City, NY 13790-2198

Mailing address

18 Broad. St - HCA
Johnson City, NY 13790-2198
Phone (607) 798-7117

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
X007360-1NYMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1205167574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 BROAD. ST - HCA",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902198",
            "telephone_number": "607-798-7117",
            "fax_number": "607-798-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 BROAD ST.",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902198",
            "telephone_number": "607-798-7117",
            "fax_number": "607-798-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMONT",
        "first_name": "JACQUELINE",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-26",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "X007360-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.