Jgertelle S Payne, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

008341-1 Issued in NY

Practice address

21 Conklin Ave
Brooklyn, NY 11236-3625

Phone

(321) 263-1344

NPI assigned

Jul 12, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

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": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499817600000",
    "number": "1336661107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CONKLIN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363625",
            "telephone_number": "321-262-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CONKLIN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363625",
            "telephone_number": "321-263-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "JGERTELLE",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2017-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "0083411",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "008341-1",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "0083411",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "008341-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Payless Lens Lab, Inc.
• Abigail Payne-Meili, LMSW
• Ancil S Payne, LCSW
• Chiquita Payne
• Dashana Payne
• Mersedes K Payne
• Raquel Aria Payne, MS, CCC-SLP
• Rosamond Payne, NP
• St.Clair C Payne, CASAC
• Whitnee Payne

• Physical Therapy Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2017; 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.