Professional Orthopedic and Sports Physical Therapy of NJ, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY OF NJ, LLC

Practice address

524 Williamstown Rd
Suite B1
Sicklerville, NJ 08081-1800

Phone

(856) 516-0591

NPI assigned

May 16, 2016

Last updated

Mar 28, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, P.C.As reported in NPPES

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

Authorized official

Name

Kathleen Brush

Title

Credentialing Coordinator Manager

Phone

(718) 819-6805

Specialties & licenses 2

Addresses

Part of

Professional Orthopedic Sports PT

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Professional Orthopedic and Sports Physical Therapy, P.C.

  • Physical Therapist
  • Montville, NJ
  • NPI 1700387966
  NPPES parent name

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522195200000",
    "number": "1316394745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859",
            "fax_number": "631-396-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 WILLIAMSTOWN RD",
            "address_2": "SUITE B1",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080811800",
            "telephone_number": "856-516-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY OF NJ, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, P.C.",
        "enumeration_date": "2016-05-16",
        "last_updated": "2018-03-28",
        "status": "A",
        "authorized_official_last_name": "BRUSH",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR MANAGER",
        "authorized_official_telephone_number": "718-819-6805"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premium Therapeutics
• Rochelle Prevard, FNP-C
• Mark D. Price, RPH, CCP
• Professional Community Support Services
• Professional Occupational & Physical Therapy, PLLC
• Providers of Care Inc (n/a)
• Tiffany Purnell
• Rafha Inc
• Gaithri Ramanathan, O.D.
• Ravora Health LLC

• Physical Therapist in Sicklerville, NJ
• Providers in Sicklerville, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; 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.