Mackenzie Logan Purr, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01992500 Issued in NJ

Practice address

23659 Columbus Rd Ste 3
Columbus, NJ 08022-1980

Phone

(609) 416-3400

Fax

(609) 379-6858

NPI assigned

Mar 22, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

• Ivyrehab Network Inc.

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1174577274
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1588240428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 STRAWBRIDGE DR STE 100",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080574602",
            "telephone_number": "856-677-4000",
            "fax_number": "856-234-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23659 COLUMBUS RD STE 3",
            "city": "COLUMBUS",
            "state": "NJ",
            "postal_code": "080221980",
            "telephone_number": "609-416-3400",
            "fax_number": "609-379-6858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURR",
        "first_name": "MACKENZIE",
        "middle_name": "LOGAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01992500",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT029373",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prathibha Potharlanka LLC (Advance Medicine and Wellness)
• Premier Medicine Associates PA
• Puccio Chiropractic LLC
• Nicholas Andrew Puccio, D.C.
• Eric Brian Pullen, RP
• Brandi J Rappaport, MD
• Hajira Naaz Razak, M.D.
• Howard William Redlus, DVM
• Refuge Chiropractic LLC (Refuge Chiropractic)
• Anthony Joseph Reid, PT, DPT

• Physical Therapist in Columbus, NJ
• Providers in Columbus, 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 Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.