Organization Active NPI

Trumble Physical Therapy, PLLC

  • Physical Therapy Clinic/Center
  • Ithaca, NY
National Provider Identifier
1508255761
Registry record updated Jan 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
013783 Issued in NY
Legal business name
TRUMBLE PHYSICAL THERAPY, PLLC
Practice address
840 Hanshaw Rd
Ithaca, NY 14850-1589
Phone
(607) 273-4972
Fax
(607) 273-4972
NPI assigned
Jan 12, 2015
Last updated
Jan 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2015

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

Authorized official

Name
Mrs. Christine Trumble, PT, OCSNPI 1407926199
Title
Owner
Phone
(607) 273-4972

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 013783 NY Primary

Addresses

Primary practice location

840 Hanshaw Rd
Ithaca, NY 14850-1589

Mailing address

840 Hanshaw Rd
Ithaca, NY 14850-1589
Phone (607) 273-4972

Other identifiers 3

IdentifierTypeStateIssuer
DD0745OtherNYMEDICARE ID TYPE UNSPECIFIED
02309662MedicaidNY
1407926199OtherNYNPI - INDIVIDUAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150513001814 NY Part B Supplier - Clinic/Group Practice 2062732100 Receives reassigned benefits from 5 practitioners
Practice locations: Ithaca, NY

National Provider Directory

National Provider Directory

Locations

840 Hanshaw Rd
Ste 13
Ithaca, NY 14850
Phone (607) 257-0567

1901 Vestal Pkwy E
Ste 1
Vestal, NY 13850

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421020800000",
    "number": "1508255761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 HANSHAW RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501589",
            "telephone_number": "607-273-4972",
            "fax_number": "607-273-4972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 HANSHAW RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501589",
            "telephone_number": "607-273-4972",
            "fax_number": "607-273-4972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUMBLE PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-12",
        "last_updated": "2015-01-12",
        "status": "A",
        "authorized_official_last_name": "TRUMBLE",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-273-4972",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT, OCS"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "013783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID TYPE UNSPECIFIED",
            "identifier": "DD0745",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02309662",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI - INDIVIDUAL",
            "identifier": "1407926199",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.