Individual provider Active NPI

Rachael Abimbola. Adams, PTA

  • Physical Therapy Assistant
  • Somerset, NJ
National Provider Identifier
1649550773
Registry record updated Aug 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
40QB00131300 Issued in NJ
Practice address
380 Demott LN
Somerset, NJ 08873-2762
Phone
(732) 873-2000
NPI assigned
Aug 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 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 40QB00131300 NJ Primary

Addresses

Primary practice location

380 Demott LN
Somerset, NJ 08873-2762

Mailing address

PO Box 3894
Union, NJ 07083-1890
Phone (908) 247-0936

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
40QB00131300NJMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1313798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313798400000",
    "number": "1649550773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3894",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070831890",
            "telephone_number": "908-247-0936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 DEMOTT LN",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088732762",
            "telephone_number": "732-873-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "RACHAEL",
        "middle_name": "ABIMBOLA.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-20",
        "last_updated": "2011-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00131300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.