Active NPI
Raymond Wade Ransom, ATC, PTA
- Physical Therapy Assistant
- South Orange, NJ
National Provider Identifier
1306067426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 40QB00190100
- Practice address
- 400 S Orange Ave
Recreation Center
South Orange, NJ 07079-2646 - Phone
- (973) 313-6394
- NPI assigned
- May 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 40QB00190100 | NJ | Primary |
| Athletic Trainer | 2255A2300X | 25MT00138700 | NJ |
Addresses
Primary practice location
400 S Orange Ave
Recreation Center
South Orange, NJ 07079-2646
Mailing address
66 Pleasantview Dr
Apt. a
Piscataway, NJ 08854-3446
Phone (732) 424-6410
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
| License | State | Type | Specialty |
|---|---|---|---|
| 40QB00190100 | NJ | MD | Physical Therapy Assistant |
| 25MT00138700 | NJ | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1306067426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 PLEASANTVIEW DR",
"address_2": "APT. A",
"city": "PISCATAWAY",
"state": "NJ",
"postal_code": "088543446",
"telephone_number": "732-424-6410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 S ORANGE AVE",
"address_2": "RECREATION CENTER",
"city": "SOUTH ORANGE",
"state": "NJ",
"postal_code": "070792646",
"telephone_number": "973-313-6394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANSOM",
"first_name": "RAYMOND",
"middle_name": "WADE",
"name_prefix": "Mr.",
"credential": "ATC, PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-02",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NJ",
"license": "40QB00190100",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NJ",
"license": "25MT00138700",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.