NPIMap

Organization Active NPI

Distinct Physical Therapy LLC

  • Physical Therapist
  • Jackson, NJ
National Provider Identifier
1386879815
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00519800 Issued in NJ
Legal business name
DISTINCT PHYSICAL THERAPY LLC
Practice address
558 Buttonwood Dr
Jackson, NJ 08527-4906
Phone
(732) 890-4866
NPI assigned
May 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

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

Authorized official

Name
Mrs. Yvonne Van Bochove, PTNPI 1629196506
Title
Owner
Phone
(732) 890-4866

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 40QA00519800 NJ Primary

Addresses

Primary practice location

558 Buttonwood Dr
Jackson, NJ 08527-4906

Mailing address

558 Buttonwood Dr
Jackson, NJ 08527-4906
Phone (732) 890-4866

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1243468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299024000000",
    "number": "1386879815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "558 BUTTONWOOD DR",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085274906",
            "telephone_number": "732-890-4866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 BUTTONWOOD DR",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085274906",
            "telephone_number": "732-890-4866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTINCT PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-28",
        "last_updated": "2011-03-02",
        "status": "A",
        "authorized_official_last_name": "VAN BOCHOVE",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-890-4866",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00519800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; 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.