Individual provider Active NPI

Raymond Wade Ransom, ATC, PTA

  • Physical Therapy Assistant
  • South Orange, NJ
National Provider Identifier
1306067426
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
40QB00190100 Issued in NJ
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

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
40QB00190100NJMDPhysical Therapy Assistant
25MT00138700NJMDAthletic 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.

Verify at the official NPI Registry.