Judah L Phipps, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

06005552A Issued in IN

Practice address

407 E Market St Ste 102
Crawfordsville, IN 47933-1852

Phone

(765) 362-1500

NPI assigned

May 8, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1588896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588896000000",
    "number": "1316569726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7879 S 700 W",
            "city": "WILLIAMSPORT",
            "state": "IN",
            "postal_code": "479938264",
            "telephone_number": "765-426-3768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E MARKET ST STE 102",
            "city": "CRAWFORDSVILLE",
            "state": "IN",
            "postal_code": "479331852",
            "telephone_number": "765-362-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHIPPS",
        "first_name": "JUDAH",
        "middle_name": "L",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-08",
        "last_updated": "2020-05-08",
        "certification_date": "2020-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06005552A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "06005552A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James M Pearce, M.D.
• Cortney Pendleton
• Kaitlyn Renee Petryszyn, LAT, ATC
• Jennifer R Peverly, LCSW
• Jonathan Pfleegor
• Physiotherapy Associates Inc
• Gregory T Pietz, O.D.
• Lauryn Pike, RBT
• Kenneth J. Pilcher, D.D.S.
• Pinnacle Dermatology, SC

• Physical Therapy Assistant in Crawfordsville, IN
• Providers in Crawfordsville, IN by specialty
• Physical Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2020; 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.