Individual provider Active NPI

Pamela Lynn Pietro, PT

  • Physical Therapist
  • Willow Grove, PA
National Provider Identifier
1417302191
Registry record updated Apr 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
36PT013788L Issued in PA
Practice address
2510 Maryland Rd
Suite 250
Willow Grove, PA 19090-1109
Phone
(215) 481-5884
NPI assigned
Apr 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 36PT013788L PA Primary

Addresses

Primary practice location

2510 Maryland Rd
Suite 250
Willow Grove, PA 19090-1109

Mailing address

2510 Maryland Rd
Suite 250
Willow Grove, PA 19090-1109
Phone (215) 481-5884

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

LicenseStateTypeSpecialty
36PT013788LPAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461888000000",
    "number": "1417302191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 MARYLAND RD",
            "address_2": "SUITE 250",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901109",
            "telephone_number": "215-481-5884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 MARYLAND RD",
            "address_2": "SUITE 250",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901109",
            "telephone_number": "215-481-5884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETRO",
        "first_name": "PAMELA",
        "middle_name": "LYNN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-29",
        "last_updated": "2016-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "36PT013788L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Grove, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; 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.