Active NPI
Timothy Eugene Vandyke, PHYSICAL THERAPIST A
- Physical Therapy Assistant
- East Windsor, NJ
National Provider Identifier
1316972243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 40QB00201100
- Practice address
- 300 Princeton Hightstown Road
Building a Ste 201
East Windsor, NJ 08520-1411 - Phone
- (609) 426-4442
- Fax
- (609) 443-0910
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 40QB00201100 | NJ | Primary |
Addresses
Primary practice location
300 Princeton Hightstown Road
Building a Ste 201
East Windsor, NJ 08520-1411
Mailing address
300A Princeton Hightstown Rd
Ste 201
East Windsor, NJ 08520-1411
Phone (609) 426-4442
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
| License | State | Type | Specialty |
|---|---|---|---|
| 40QB00201100 | NJ | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wallop Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Plainsboro, NJ
- NPI 1497894794
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316972243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300A PRINCETON HIGHTSTOWN RD",
"address_2": "STE 201",
"city": "EAST WINDSOR",
"state": "NJ",
"postal_code": "085201411",
"telephone_number": "609-426-4442",
"fax_number": "609-443-0910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PRINCETON HIGHTSTOWN ROAD",
"address_2": "BUILDING A STE 201",
"city": "EAST WINDSOR",
"state": "NJ",
"postal_code": "085201411",
"telephone_number": "609-426-4442",
"fax_number": "609-443-0910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDYKE",
"first_name": "TIMOTHY",
"middle_name": "EUGENE",
"name_prefix": "Mr.",
"credential": "PHYSICAL THERAPIST A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NJ",
"license": "40QB00201100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Windsor, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.