Active NPI
Mitchell Wood Raymond, PT
- Physical Therapist
- Ithaca, NY
National Provider Identifier
1659678571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 033124-1
- Practice address
- 1229 Trumansburg Rd
Ithaca, NY 14850-1313 - Phone
- (607) 273-8072
- NPI assigned
- Feb 13, 2011
- Last updated
- Mar 18, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 033124-1 | NY | Primary |
Addresses
Primary practice location
1229 Trumansburg Rd
Ithaca, NY 14850-1313
Mailing address
1229 Trumansburg Rd, Ithaca, Ny 14850
Ithaca, NY 14850
Phone (607) 273-8072
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
| License | State | Type | Specialty |
|---|---|---|---|
| 033124-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458259200000",
"number": "1659678571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1229 TRUMANSBURG RD, ITHACA, NY 14850",
"city": "ITHACA",
"state": "NY",
"postal_code": "14850",
"telephone_number": "607-273-8072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1229 TRUMANSBURG RD",
"city": "ITHACA",
"state": "NY",
"postal_code": "148501313",
"telephone_number": "607-273-8072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAYMOND",
"first_name": "MITCHELL",
"middle_name": "WOOD",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-02-13",
"last_updated": "2016-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "033124-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.