Edge Physical Therapy and Sports Medicine LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01510100 Issued in NJ

Legal business name

EDGE PHYSICAL THERAPY AND SPORTS MEDICINE LLC

Practice address

407 Sette Dr
Paramus, NJ 07652-2940

Phone

(201) 783-2332

NPI assigned

Aug 14, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Lawrence Kim, PT, DPT, OCSNPI 1154755288

Title

Managing Director

Phone

(201) 783-2332

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Tax ID family

Edge Physical Therapy and Sports Medicine LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Edge Physical Therapy and Sports Medicine LLC

  • Physical Therapist
  • Paramus, NJ
  • NPI 1558737395
  NPD tax ID

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lawrence Kim, DPT

  • Physical Therapist
  • Elmwood Park, NJ
  • NPI 1154755288
  Medicare reassignment Care Compare group NPD Authorized official
• Nicholas Martinez

  • Physical Rehabilitation Occupational Therapist
  • Paramus, NJ
  • NPI 1417827031
  Medicare reassignment Care Compare group NPD
• Giancarlo Rozon

  • Physical Therapist
  • Westwood, NJ
  • NPI 1407310683
  Medicare reassignment Care Compare group NPD
• Mackenzie Taylor Merkel, PT

  • Physical Therapist
  • Boonton, NJ
  • NPI 1801554183
  Medicare reassignment NPD

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

{
    "created_epoch": "1439510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439510400000",
    "number": "1467828301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 SETTE DR",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076522940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 SETTE DR",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076522940",
            "telephone_number": "201-783-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGE PHYSICAL THERAPY AND SPORTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-14",
        "last_updated": "2015-08-14",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "201-783-2332",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT, OCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01510100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn E Farrell, LSW, LCADC
• Shelby Lynn Ebbighausen
• Christopher Ecochard, LAC, LCADC
• Eden Ambulance Corporation
• Edge Orthotics, Inc.
• Edge Physical Therapy and Sports Medicine LLC
• Edge Pro Sports Rehab Institute, LLC
• Aaron Ehrlich
• Emily Ehrmann, MA
• Sebastian Eid, MD

• Physical Therapist in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.