Active NPI
Andrew Mallon, DPT
- Specialist
- Atco, NJ
National Provider Identifier
1285043430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 40QA01559600
- Practice address
- 273 Front St
Atco, NJ 08004-1958 - Phone
- (856) 237-4703
- NPI assigned
- Aug 12, 2014
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01559600 | NJ | |
| Sports Physical Therapist | 2251S0007X | |||
| Orthopedic Physical Therapist | 2251X0800X | |||
| Specialist | 174400000X | 40QA01559600 | NJ | Primary |
Addresses
Primary practice location
273 Front St
Atco, NJ 08004-1958
Mailing address
273 Front St
Atco, NJ 08004-1958
Phone (856) 237-4703
Other practice location 1
1035 N Black Horse Pike
Suite 5
Williamstown, NJ 08094-2840
Phone (856) 728-4100 ext. 4
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
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA01559600 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ipta Clinical, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507593600000",
"number": "1285043430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "273 FRONT ST",
"city": "ATCO",
"state": "NJ",
"postal_code": "080041958",
"telephone_number": "856-237-4703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "273 FRONT ST",
"city": "ATCO",
"state": "NJ",
"postal_code": "080041958",
"telephone_number": "856-237-4703"
}
],
"practiceLocations": [
{
"address_1": "1035 N Black Horse Pike",
"address_2": "Suite 5",
"address_purpose": "LOCATION",
"city": "Williamstown",
"state": "NJ",
"postal_code": "080942840",
"country_code": "US",
"telephone_number": "856-728-4100 x4",
"fax_number": "856-728-4415",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MALLON",
"first_name": "ANDREW",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-12",
"last_updated": "2017-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01559600",
"primary": false
},
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": null,
"license": null,
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": null,
"license": null,
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NJ",
"license": "40QA01559600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atco, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.