Individual provider Active NPI

Owen M Lennon, DPT

  • Physical Therapist
  • Clifton, NJ
National Provider Identifier
1518150606
Registry record updated Apr 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01391100 Issued in NJ
Practice address
2 Brighton Rd
Suite 406
Clifton, NJ 07012-1663
Phone
(973) 928-6969
Fax
(973) 928-6968
NPI assigned
Aug 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT3289 ME
Physical Therapist 225100000X 40QA01391100 NJ Primary

Addresses

Primary practice location

2 Brighton Rd
Suite 406
Clifton, NJ 07012-1663

Mailing address

2 Brighton Rd
Suite 406
Clifton, NJ 07012-1663
Phone (973) 928-6969

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT3289MEMDPhysical Therapist
40QA01391100NJMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1518150606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BRIGHTON RD",
            "address_2": "SUITE 406",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121663",
            "telephone_number": "973-928-6969",
            "fax_number": "973-928-6968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BRIGHTON RD",
            "address_2": "SUITE 406",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121663",
            "telephone_number": "973-928-6969",
            "fax_number": "973-928-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENNON",
        "first_name": "OWEN",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-22",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT3289",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01391100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; 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.