Jeremy Oldham

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

TEI000994 Issued in PA

Practice address

208 Pennknoll Rd
Everett, PA 15537-6940

Phone

(814) 623-3240

NPI assigned

Feb 7, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1360195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360195200000",
    "number": "1316286578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "688 E WATSON ST",
            "city": "BEDFORD",
            "state": "PA",
            "postal_code": "155222106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 PENNKNOLL RD",
            "city": "EVERETT",
            "state": "PA",
            "postal_code": "155376940",
            "telephone_number": "814-623-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDHAM",
        "first_name": "JEREMY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-07",
        "last_updated": "2013-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TEI000994",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A2867",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Musselman
• Eric W Nelson, PA-C
• Alysha Norris
• Cassidy Skye Nouse, MS, RDN, LDN
• Mark Oherrick
• Kylee Oldham
• Op Everett, LLC
• Vanessa I Orris, MSN, FNP-C
• Daniel Justin Parks, CRNA
• Arpankumar Patel, MD

• Physical Therapy Assistant in Everett, PA
• Providers in Everett, PA by specialty
• Physical Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; 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.