Active NPI
James T Ahlstrom, PT, DPT
- Physical Therapist
- Hawthorne, NV
National Provider Identifier
1669956041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3842
- Practice address
- 200 S a St
Hawthorne, NV 89415 - Phone
- (775) 945-2461
- NPI assigned
- Sep 20, 2018
- Last updated
- Oct 13, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 | 3842 | NV | Primary |
Addresses
Primary practice location
200 S a St
Hawthorne, NV 89415
Mailing address
112 W 5TH St
Box 1554
Hawthorne, NV 89415-4256
Phone (208) 244-8202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200403001627 | NV | Practitioner - Physical Therapist in Private Practice | 7810326386 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3842 | NV | MD | Physical Therapist |
Interoperability endpoints
- james.ahlstrom.1@11938.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634083200000",
"number": "1669956041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 W 5TH ST",
"address_2": "BOX 1554",
"city": "HAWTHORNE",
"state": "NV",
"postal_code": "894154256",
"telephone_number": "208-244-8202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 S A ST",
"city": "HAWTHORNE",
"state": "NV",
"postal_code": "89415",
"telephone_number": "775-945-2461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHLSTROM",
"first_name": "JAMES",
"middle_name": "T",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-09-20",
"last_updated": "2021-10-13",
"certification_date": "2021-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NV",
"license": "3842",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hawthorne, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; 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.