Camelot Rehabilitation LLC

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

40QA00640600 Issued in NJ

Legal business name

CAMELOT REHABILITATION LLC

Practice address

656 Shrewsbury Ave
Suite 102
Tinton Falls, NJ 07701-4964

Phone

(732) 747-2300

Fax

(732) 747-2334

NPI assigned

Oct 25, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Kathryn Mary Shapiro, P.T.

Title

Owner

Phone

(732) 747-2300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462233600000",
    "number": "1427358407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "656 SHREWSBURY AVE",
            "address_2": "SUITE 102",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014964",
            "telephone_number": "732-747-2300",
            "fax_number": "732-747-2334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "656 SHREWSBURY AVE",
            "address_2": "SUITE 102",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014964",
            "telephone_number": "732-747-2300",
            "fax_number": "732-747-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELOT REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-25",
        "last_updated": "2016-05-03",
        "status": "A",
        "authorized_official_last_name": "SHAPIRO",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-747-2300",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NJ",
            "license": "40QA00640600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "188607",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Physical Therapist in Tinton Falls, NJ
• Providers in Tinton Falls, NJ by specialty
• Geriatric Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.