Active NPI
Peter Bannan, DPT
- Physical Therapist
- Burlington, NJ
National Provider Identifier
1528477528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA01557100
- Practice address
- 2305 Rancocas Rd
Burlington, NJ 08016-4113 - Phone
- (609) 747-8619
- NPI assigned
- Aug 5, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01557100 | NJ | Primary |
Addresses
Primary practice location
2305 Rancocas Rd
Burlington, NJ 08016-4113
Mailing address
1111 Oriental Ave
Haddon Township, NJ 08108-2038
Phone (609) 315-2484
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA01557100 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407196800000",
"number": "1528477528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 ORIENTAL AVE",
"city": "HADDON TOWNSHIP",
"state": "NJ",
"postal_code": "081082038",
"telephone_number": "609-315-2484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2305 RANCOCAS RD",
"city": "BURLINGTON",
"state": "NJ",
"postal_code": "080164113",
"telephone_number": "609-747-8619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANNAN",
"first_name": "PETER",
"name_prefix": "Mr.",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-08-05",
"last_updated": "2014-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01557100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlington, NJ
- Denise Ball, BA
- Bancroft, a New Jersey Nonprofit Corporation
- Bancroft, a New Jersey Nonprofit Corporation
- Bancroft, a New Jersey Nonprofit Corporation
- Madeline M Bandomer, PHARMD, RPH
- Joanne Barone, LPN
- Paulette Barrington, LPN
- Rosalina Barroso, LPN
- Roseann Bartolomeo, COTA
- Seferina Rebecca Batista, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.