Individual provider Active NPI

Jean S. Wurst

  • Physical Therapy Assistant
  • Erie, PA
National Provider Identifier
1609153014
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
TE1000749 Issued in PA
Practice address
2101 Nagle Rd
Erie, PA 16510-2189
Phone
(814) 877-7078
NPI assigned
Nov 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TE1000749 PA Primary

Addresses

Primary practice location

2101 Nagle Rd
Erie, PA 16510-2189

Mailing address

2101 Nagle Rd
Erie, PA 16510-2189

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

LicenseStateTypeSpecialty
TE1000749PAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1609153014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 NAGLE RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165102189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 NAGLE RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165102189",
            "telephone_number": "814-877-7078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WURST",
        "first_name": "JEAN",
        "middle_name": "S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-14",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE1000749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; 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.