Justin Gregory Delong

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT003716 Issued in WV

Practice address

1 Healthy Way
Berkeley Springs, WV 25411-7463

Phone

(304) 258-6516

NPI assigned

Dec 27, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1545868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1306318647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 ROOFTOP CT",
            "city": "STEPHENSON",
            "state": "VA",
            "postal_code": "226561983",
            "telephone_number": "916-743-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "BERKELEY SPRINGS",
            "state": "WV",
            "postal_code": "254117463",
            "telephone_number": "304-258-6516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELONG",
        "first_name": "JUSTIN",
        "middle_name": "GREGORY",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-27",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305212262",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "PT003716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1 Healthy Way",
            "city": "Berkeley Springs",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254117463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brenda Cramer
• Ashley D Crone
• Anthony Abiola Dasilva, MD
• Tammy Walker Davison, RPH
• Dayspring, Inc. (Berkeley Springs Rehab. and Nursing)
• Lucas Spencer Diehl
• Timothy John Dipietro
• Nicole Disch, OT
• Tina Ditto
• Mae Marie Dixon

• Physical Therapist in Berkeley Springs, WV
• Providers in Berkeley Springs, WV by specialty
• Physical Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.