Jamie Shannon Soutar, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

J2-0000488 Issued in DE

Practice address

130 Executive Dr
Newark, DE 19702-3349

Phone

(302) 292-3454

Fax

(302) 292-3464

NPI assigned

May 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295781243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 TINSLEY CT",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197022819",
            "telephone_number": "302-266-7122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 EXECUTIVE DR",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197023349",
            "telephone_number": "302-292-3454",
            "fax_number": "302-292-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTAR",
        "first_name": "JAMIE",
        "middle_name": "SHANNON",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "DE",
            "license": "J2-0000488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly C Sorensen
• Bijan Sorouri, M.D.
• Parviz Sorouri, M.D.
• Amarnath G Sortur, MD
• Mina Maher Sous, MD
• Robert Christopher South, D.C.
• Southern Delaware Sportscare and Rehabilitation, LLC
• Sovhealth Properties, LLC
• Jennifer Soviero, DC, CFNMP
• David T Sowa, MD

• Physical Therapy Assistant in Newark, DE
• Providers in Newark, DE by specialty
• Physical Therapy Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.