Jennifer M Pulisic

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

2305003363 Issued in VA

Practice address

203 N Washington Hwy
Ashland, VA 23005-1623

Phone

(804) 798-1112

NPI assigned

Aug 3, 2021

Last updated

Aug 6, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1528732724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NEW FIDELITY CT",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292665",
            "telephone_number": "919-258-2714",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 N WASHINGTON HWY",
            "city": "ASHLAND",
            "state": "VA",
            "postal_code": "230051623",
            "telephone_number": "804-798-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULISIC",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "VA",
            "license": "2305003363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenny Place, DPT
• Gregory Podolak
• Edward Spencer Powers, LPC, ATR-BC
• Angela Marie Pressley
• Jessica Elizabeth Price
• Matthew Pulisic, DPT MS OCS
• Janet E Purcell-Baserap, MS, OTR/L
• Brooke Mackenzie Purcell
• Kemelee M Puryear, RN
• Ronald Puryear

• Pediatric Physical Therapist in Ashland, VA
• Providers in Ashland, VA by specialty
• Pediatric Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.