Center for Sports Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

CENTER FOR SPORTS PHYSICAL THERAPY, LLC

Practice address

535 Iron Bridge Rd Ste 12
Freehold, NJ 07728-5301

Phone

(732) 567-0834

NPI assigned

May 2, 2024

Organization subpart

No

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

Authorized official

Name

Jessie Ganon, PTNPI 1447497987

Title

Owner/Medical Provider

Phone

(732) 567-0834

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessie Ganon, PT

  • Physical Therapist
  • Freehold, NJ
  • NPI 1447497987
  Medicare reassignment Care Compare group NPD Authorized official
• Charmaine C Tiu, PT

  • Physical Therapist
  • Morganville, NJ
  • NPI 1902064959
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1714608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714608000000",
    "number": "1568219954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18-8 AUGUSTA CT",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077283632",
            "telephone_number": "732-567-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 IRON BRIDGE RD STE 12",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077285301",
            "telephone_number": "732-567-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR SPORTS PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "GANON",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "OWNER/MEDICAL PROVIDER",
        "authorized_official_telephone_number": "732-567-0834",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Marie Cavalieri, FNP
• Rose Marie Cedola, OTR
• Center for Infectious Diseases and Intl. Travel Care of Monmouth, P.C.
• Center for Network Therapy
• Center for Periodontal Health
• Center for Vein Restoration NJ LLC
• Central Jersey Bariatrics, LLC
• Central Jersey Emergency Medicine Associates, PC
• Central Jersey Emergency Medicine Asst.
• Central Jersey Gastroenterology Associates PA

• Physical Therapist in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; 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.