Active NPI
Anne Marie Collum, PT, DPT
- Pediatric Physical Therapist
- Lafayette, NJ
National Provider Identifier
1396200432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 40QA00917900
- Practice address
- 156 State Route 15
Lafayette, NJ 07848-2607 - Phone
- (973) 862-6377
- NPI assigned
- Feb 3, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 40QA00917900 | NJ | Primary |
Addresses
Primary practice location
156 State Route 15
Lafayette, NJ 07848-2607
Mailing address
33 Glencove Rd
Morris Plains, NJ 07950-3147
Phone (973) 714-5686
Other practice location 1
142 Totowa Rd
Totowa, NJ 07512-2745
Phone (973) 237-1975
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 |
|---|---|---|---|
| 40QA00917900 | NJ | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Performance Pediatrics | Multi-Specialty | Past | Accepting new patients |
| Damon Physical Therapy | Pediatrics | Past | Accepting new patients |
| Performance Rehabilitation, PC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
Organizations & group practices 3
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549152000000",
"number": "1396200432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 GLENCOVE RD",
"city": "MORRIS PLAINS",
"state": "NJ",
"postal_code": "079503147",
"telephone_number": "973-714-5686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "156 STATE ROUTE 15",
"city": "LAFAYETTE",
"state": "NJ",
"postal_code": "078482607",
"telephone_number": "973-862-6377"
}
],
"practiceLocations": [
{
"address_1": "142 Totowa Rd",
"address_purpose": "LOCATION",
"city": "Totowa",
"state": "NJ",
"postal_code": "075122745",
"country_code": "US",
"telephone_number": "973-237-1975",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COLLUM",
"first_name": "ANNE MARIE",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-03",
"last_updated": "2019-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist, Pediatrics",
"state": "NJ",
"license": "40QA00917900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.