Active NPI
Jeremy W Earl, PT
- Physical Therapist
- Utica, NY
National Provider Identifier
1407001035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 021116-1
- Practice address
- 1601 Armory Dr
Building a
Utica, NY 13501-5405 - Phone
- (315) 798-4006
- Fax
- (315) 798-4004
- NPI assigned
- Nov 24, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 021116-1 | NY | Primary |
Addresses
Primary practice location
1601 Armory Dr
Building a
Utica, NY 13501-5405
Mailing address
116 Dryden Ave
Utica, NY 13502-5716
Phone (315) 725-1152
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 |
|---|---|---|---|
| 021116-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227484800000",
"number": "1407001035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 DRYDEN AVE",
"city": "UTICA",
"state": "NY",
"postal_code": "135025716",
"telephone_number": "315-725-1152",
"fax_number": "315-798-4004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 ARMORY DR",
"address_2": "BUILDING A",
"city": "UTICA",
"state": "NY",
"postal_code": "135015405",
"telephone_number": "315-798-4006",
"fax_number": "315-798-4004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EARL",
"first_name": "JEREMY",
"middle_name": "W",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-11-24",
"last_updated": "2008-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "021116-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Utica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.