NPIMap

Organization Active NPI

Rise Home Therapy, LLC

  • Geriatric Physical Therapist
  • West Deptford, NJ
National Provider Identifier
1639426141
Registry record updated Feb 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
40QA00274100 Issued in NJ
Legal business name
RISE HOME THERAPY, LLC
Practice address
82 Pelican Place
West Deptford, NJ 08086
Phone
(856) 345-4830
Fax
(856) 853-0769
NPI assigned
Aug 14, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2018

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

Authorized official

Name
Mr. Brian Keith Homan Sr., PT
Title
Manager/Owner
Phone
(856) 345-4830

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251G0304X 40QA00274100 NJ Primary

Addresses

Primary practice location

82 Pelican Place
West Deptford, NJ 08086

Mailing address

82 Pelican Place
West Deptford, NJ 08086
Phone (856) 345-4830

Other names 1

  • Brian Homan, PT LLC Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519603200000",
    "number": "1639426141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 PELICAN PLACE",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "08086",
            "telephone_number": "856-345-4830",
            "fax_number": "856-853-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 PELICAN PLACE",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "08086",
            "telephone_number": "856-345-4830",
            "fax_number": "856-853-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISE HOME THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-14",
        "last_updated": "2018-02-26",
        "status": "A",
        "authorized_official_last_name": "HOMAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "856-345-4830",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NJ",
            "license": "40QA00274100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brian Homan, PT LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in West Deptford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; 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.