NPIMap

Organization Active NPI

Balance and Vestibular Center of King of Prussia LLC

  • Physical Therapy Clinic/Center
  • King of Prussia, PA
National Provider Identifier
1336661750
Registry record updated Jul 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT015319 Issued in PA
Legal business name
BALANCE AND VESTIBULAR CENTER OF KING OF PRUSSIA LLC
Practice address
1004 W 9TH Ave Ste 100
King of Prussia, PA 19406-1217
Phone
(610) 265-5305
Fax
(610) 265-5306
NPI assigned
Jul 7, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2017

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

Authorized official

Name
Ling Patricia Chang, PT, PHDNPI 1609043983
Title
Owner
Phone
(610) 265-5305

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT015319 PA
Physical Therapy Clinic/Center 261QP2000X PT015319 PA Primary

Addresses

Primary practice location

1004 W 9TH Ave Ste 100
King of Prussia, PA 19406-1217

Mailing address

1004 W 9TH Ave Ste 100
King of Prussia, PA 19406-1217
Phone (610) 265-5305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171003006956 PA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9032484977 Receives reassigned benefits from 1 practitioner
Practice locations: King of Prussia, PA

National Provider Directory

National Provider Directory

Locations

1004 W 9th Ave
Ste 100
Kng of Prussa, PA 19406
Phone (610) 265-5305

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499385600000",
    "number": "1336661750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 W 9TH AVE STE 100",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061217",
            "telephone_number": "610-265-5305",
            "fax_number": "610-265-5306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 W 9TH AVE STE 100",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061217",
            "telephone_number": "610-265-5305",
            "fax_number": "610-265-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCE AND VESTIBULAR CENTER OF KING OF PRUSSIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-07",
        "last_updated": "2017-07-07",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "LING",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-265-5305",
        "authorized_official_credential": "PT, PHD"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT015319",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "PA",
            "license": "PT015319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King of Prussia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.