Active NPI
Malik Patterson, PTA
- Physical Therapy Assistant
- Glen Mills, PA
National Provider Identifier
1346981347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- Practice address
- 300 Evergreen Dr Ste 200
Glen Mills, PA 19342-1059 - Phone
- (610) 876-0347
- Fax
- (610) 482-9409
- NPI assigned
- Apr 5, 2022
- Last updated
- Apr 5, 2022
- 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 | NU | Primary |
Addresses
Primary practice location
300 Evergreen Dr Ste 200
Glen Mills, PA 19342-1059
Mailing address
PO Box 5228
West Chester, PA 19380-0405
Phone (610) 359-5671
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649116800000",
"number": "1346981347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5228",
"city": "WEST CHESTER",
"state": "PA",
"postal_code": "193800405",
"telephone_number": "610-359-5671",
"fax_number": "610-482-9409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 EVERGREEN DR STE 200",
"city": "GLEN MILLS",
"state": "PA",
"postal_code": "193421059",
"telephone_number": "610-876-0347",
"fax_number": "610-482-9409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "MALIK",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-05",
"last_updated": "2022-04-05",
"certification_date": "2022-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Mills, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.