Individual provider Active NPI

James Alan Shimp, MPT

  • Physical Therapist
  • Elmer, NJ
National Provider Identifier
1285601864
Registry record updated Apr 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
QAO5832 Issued in NJ
Practice address
45 Broad St
Physical Therapy Services,Rutala,Ingemi,Barbara,LLC
Elmer, NJ 08318-2201
Phone
(856) 358-6200
Fax
(856) 358-0077
NPI assigned
Mar 2, 2006
Last updated
Apr 28, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2011

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 QAO5832 NJ Primary

Addresses

Primary practice location

45 Broad St
Physical Therapy Services,Rutala,Ingemi,Barbara,LLC
Elmer, NJ 08318-2201

Mailing address

209 Porchtown Rd
Pittsgrove, NJ 08318-4522
Phone (856) 358-7797

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
QAO5832NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network Inc. Physical Therapist Current Accepting new patients
Tri-County Home and Hospice Care,LLC CurrentSince Nov 1, 2022 Accepting new patients
Tri-County Home and Hospice Care,LLC CurrentSince Oct 23, 2019 Accepting new patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince Dec 17, 2018 Accepting new patients
Ivyrehab Network Inc Physical Therapist CurrentSince Dec 17, 2018 Accepting new patients

Locations

70 Manheim Ave
Ste 3
Bridgeton, NJ 08302
Phone (856) 455-9700

45 Broad St
Elmer, NJ 08318
Phone (856) 358-6200

731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780

600 Jessup Rd
Ste 100A
West Deptford, NJ 08086
Phone (856) 845-8220

200 Campbell Dr
Ste 107
Willingboro, NJ 08046
Phone (609) 614-3997

1377 Motor Pkwy
Ste 307
Ronkonkoma, NY 11749

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303948800000",
    "number": "1285601864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 PORCHTOWN RD",
            "city": "PITTSGROVE",
            "state": "NJ",
            "postal_code": "083184522",
            "telephone_number": "856-358-7797",
            "fax_number": "856-358-3449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 BROAD ST",
            "address_2": "PHYSICAL THERAPY SERVICES,RUTALA,INGEMI,BARBARA,LLC",
            "city": "ELMER",
            "state": "NJ",
            "postal_code": "083182201",
            "telephone_number": "856-358-6200",
            "fax_number": "856-358-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMP",
        "first_name": "JAMES",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2011-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "QAO5832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmer, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; 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.