Tolan Washington, PT, CN, FUNCTIONAL M

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

1200458281 Issued in NJ

Practice address

176 Gregory Ave
West Orange, NJ 07052-4620

Phone

(973) 803-2063

NPI assigned

Jun 21, 2021

Last updated

Nov 4, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ta Washington

  dba Peakfitnessplus

  • Physical Therapy Clinic/Center
  • West Orange, NJ
  • NPI 1265197222
  NPD Authorized official

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1487223970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 GREGORY AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524620",
            "telephone_number": "973-803-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 GREGORY AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524620",
            "telephone_number": "973-803-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "TOLAN",
        "name_prefix": "Mr.",
        "credential": "PT, CN, FUNCTIONAL M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "NJ",
            "license": "1200458281",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NJ",
            "license": "1200458281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://peakfitnessplus.com/",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "176 Gregory Ave",
            "city": "West Orange",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070524620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kristina Walker, PA-C
• Lyle G Wallace
• Amanda Walstedt, LPC, LCADC
• Gileen Wambua, APN
• Paul Wangenheim, MD
• Bishoy Wassef, M.D.
• Cianna Charmaine Weary, PT, DPT
• Charles Idris Webb, LCSW
• Kristie Weimmer, APN
• Mari Weinandy, PT DPT

• Physical Rehabilitation Occupational Therapist in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Physical Rehabilitation Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; 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.