Jordan Tyler Ambrose, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

002865 Issued in WV

Practice address

172 Costello Dr
Winchester, VA 22602-4306

Phone

(540) 665-4444

NPI assigned

Jun 9, 2023

Sex

Male

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)

Not enrolled

State licenses

Practice roles

Locations

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

• Capitol Rehab of Winchester PLLC

  • Rehabilitation Chiropractor
  • Winchester, VA
  • NPI 1134314966
  NPD

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1548944762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 DOE RUN RD",
            "city": "INWOOD",
            "state": "WV",
            "postal_code": "254284128",
            "telephone_number": "304-590-6173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 COSTELLO DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226024306",
            "telephone_number": "540-665-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSE",
        "first_name": "JORDAN",
        "middle_name": "TYLER",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-09",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WV",
            "license": "002865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ramez Issam Emile Alyacoub, MD
• Amanda Morris OD and Associates, PLLC
• Amani Health & Wellness
• Angela Amann, FNP
• Esthei Amaya, PA
• Hannah Ameling
• American Medical & Diabetic Supplies, LLC
• Amherst Family Practice P C
• Rachel Amick
• Idean Amirjazil

• All providers in Winchester, VA
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; 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.