NPIMap

Organization Active NPI

Specialized Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Cherry Hill, NJ
National Provider Identifier
1225019805
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SPECIALIZED PHYSICAL THERAPY, LLC
Practice address
1930 Marlton Pike E
A7
Cherry Hill, NJ 08003-2150
Phone
(856) 424-0993
NPI assigned
Nov 9, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Paul Gregory Vidal, DPTNPI 1376524173
Title
Owner/Physical Therapist
Phone
(856) 424-0993

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

1930 Marlton Pike E
A7
Cherry Hill, NJ 08003-2150

Mailing address

1930 Marlton Pike E
A7
Cherry Hill, NJ 08003-2150
Phone (856) 424-0993

National Provider Directory

National Provider Directory

Locations

11 Cadillac Rd
Burlington, NJ 08016
Phone (609) 880-0880

1930 Marlton Pike E
Ste A7
Cherry Hill, NJ 08003
Phone (856) 424-0993

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225019805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 MARLTON PIKE E",
            "address_2": "A7",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032150",
            "telephone_number": "856-424-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 MARLTON PIKE E",
            "address_2": "A7",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032150",
            "telephone_number": "856-424-0993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VIDAL",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "856-424-0993",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.