Individual provider Active NPI

Jeremy Evan Damiano, PTA

  • Physical Therapy Assistant
  • Carlisle, PA
National Provider Identifier
1275003287
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
TEI005193 Issued in PA
Practice address
1000 Claremont Rd
Carlisle, PA 17013-7310
Phone
(717) 243-2031
NPI assigned
Dec 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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 TEI005193 PA Primary

Addresses

Primary practice location

1000 Claremont Rd
Carlisle, PA 17013-7310

Mailing address

515 Barry CT
Mechanicsburg, PA 17050-4602
Phone (717) 417-0271

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
TEI005193PAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1275003287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 BARRY CT",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170504602",
            "telephone_number": "717-417-0271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CLAREMONT RD",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170137310",
            "telephone_number": "717-243-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMIANO",
        "first_name": "JEREMY",
        "middle_name": "EVAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-03",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TEI005193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlisle, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.