Individual provider Active NPI

Jonna Kathleen Deblois, PHYSICAL THERAPIST

  • Physical Therapist
  • Plainview, NY
National Provider Identifier
1205817574
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
018085-1 Issued in NY
Practice address
875 Old Country Rd Ste 153LL
Plainview, NY 11803-4942
Phone
(516) 935-1958
Fax
(516) 827-0714
NPI assigned
Nov 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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 018085-1 NY Primary

Addresses

Primary practice location

875 Old Country Rd Ste 153LL
Plainview, NY 11803-4942

Mailing address

875 Old Country Rd Ste 153LL
Plainview, NY 11803-4942
Phone (516) 935-1958

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
018085-1NYMDPhysical Therapist
018085NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1205817574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 OLD COUNTRY RD STE 153LL",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034942",
            "telephone_number": "516-935-1958",
            "fax_number": "516-681-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 OLD COUNTRY RD STE 153LL",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034942",
            "telephone_number": "516-935-1958",
            "fax_number": "516-827-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBLOIS",
        "first_name": "JONNA",
        "middle_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "018085-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.