Individual provider Active NPI

Jamie A Jarvis, PTA

  • Physical Therapy Assistant
  • Goshen, NY
National Provider Identifier
1669532867
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
000737-1 Issued in NY
Practice address
2 Fletcher St
Goshen, NY 10924-1402
Phone
(845) 294-8806
Fax
(845) 294-8650
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 000737-1 NY Primary

Addresses

Primary practice location

2 Fletcher St
Goshen, NY 10924-1402

Mailing address

287 Guinea Hill Rd
Slate Hill, NY 10973-4317
Phone (845) 355-9131

Other names 1

  • Jamie A Jarvis-Dean Other name

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
000737-1NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669532867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 GUINEA HILL RD",
            "city": "SLATE HILL",
            "state": "NY",
            "postal_code": "109734317",
            "telephone_number": "845-355-9131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 FLETCHER ST",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109241402",
            "telephone_number": "845-294-8806",
            "fax_number": "845-294-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARVIS",
        "first_name": "JAMIE",
        "middle_name": "A",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "000737-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "JARVIS-DEAN",
            "middle_name": "A",
            "credential": "PTA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Goshen, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.