Neuro Dynamics Penn

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

NEURO DYNAMICS PENN

Practice address

100 N 18TH St
Ste 300
Philadelphia, PA 19103

Phone

(918) 770-9333

Fax

(918) 213-4888

NPI assigned

Oct 3, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Jay L KrottingerNPI 1730554031

Title

Coo

Phone

(918) 932-2734

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 2

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

• Jay L Krottinger

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Tulsa, OK
  • NPI 1730554031
  NPD Authorized official
• Alok Pratap Pasricha, M.D.

  • Neurology Physician
  • Tulsa, OK
  • NPI 1053359661
  NPD

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546992000000",
    "number": "1649745803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1430",
            "address_2": "LOCKBOX #5120",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740341430",
            "telephone_number": "918-932-2734",
            "fax_number": "918-932-2734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N 18TH ST",
            "address_2": "STE 300",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19103",
            "telephone_number": "918-770-9333",
            "fax_number": "918-213-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO DYNAMICS PENN",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-03",
        "last_updated": "2019-01-09",
        "status": "A",
        "authorized_official_last_name": "KROTTINGER",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "918-932-2734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willam Richet Neuman, MD
• Jessica Marie Neumann
• Samantha Neumann, DO
• Sulabh Neupane
• Neupath Physical Therapy LLC
• Neuro Source Diagnostics, Inc
• Neuro-Ophthalmologic Associates PC
• Neurodynamix Testing and Therapy Solutions PLLC
• Neuroflow
• Neurology and Neurophysiology Associates, P.C.

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; 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.