Individual provider Active NPI

Loren Pruitt

  • Orthopedic Physical Therapist
  • Bala Cynwyd, PA
National Provider Identifier
1669989968
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT027694 Issued in PA
Practice address
150 Monument Rd Ste 110
Bala Cynwyd, PA 19004-1725
Phone
(610) 270-0370
Fax
(610) 270-0374
NPI assigned
Jan 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01756300 NJ
Orthopedic Physical Therapist 2251X0800X PT027694 PA Primary

Addresses

Primary practice location

150 Monument Rd Ste 110
Bala Cynwyd, PA 19004-1725

Mailing address

475 Allendale Rd Ste 206
King of Prussia, PA 19406-1495
Phone (610) 270-0370

Other practice location 1

740 Marne Hwy Ste 203
Moorestown, NJ 08057-3127
Phone (856) 914-1400

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT027694PAMDOrthopedic Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1669989968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 ALLENDALE RD STE 206",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061495",
            "telephone_number": "610-270-0370",
            "fax_number": "610-270-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MONUMENT RD STE 110",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041725",
            "telephone_number": "610-270-0370",
            "fax_number": "610-270-0374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "740 Marne Hwy Ste 203",
            "address_purpose": "LOCATION",
            "city": "Moorestown",
            "state": "NJ",
            "postal_code": "080573127",
            "country_code": "US",
            "telephone_number": "856-914-1400",
            "fax_number": "856-914-1444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "LOREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-08",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01756300",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "PA",
            "license": "PT027694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.