James Joseph Detwiler Ibach, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

J2-0001279 Issued in DE

Practice address

907 N Dupont Blvd Ste 104
Milford, DE 19963-1060

Phone

(302) 422-2518

NPI assigned

Oct 8, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lakeside Physical Therapy, LLC

  • Rehabilitation Practitioner
  • Laurel, DE
  • NPI 1184854929
  NPD (past)
• PT Works de, LLC

  • Rehabilitation Practitioner
  • Milford, DE
  • NPI 1750010492
  NPD (past)

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1679048482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 S WALNUT ST",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199632329",
            "telephone_number": "302-258-9676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 N DUPONT BLVD STE 104",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199631060",
            "telephone_number": "302-422-2518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBACH",
        "first_name": "JAMES",
        "middle_name": "JOSEPH DETWILER",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-08",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "DE",
            "license": "J2-0001279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XHD127830688001",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harvey Hudson
• Lolita Sammons Hudson, COTA/L
• Lou Ann Hurst, CRNA
• Kristine L Hutchison, LPCMH, CADC
• Ashaneyia Hyland
• Chinwe Ike-Chinwo, MD
• Herve Peacemaker Ineza, DO, MBA
• Paul Inge, FNP-C
• Innovative Physical Therapy & Fitness of Delaware LLC (Innovative Healthcare Centers)
• Amanda Marie Ireland, DPT

• Physical Therapy Assistant in Milford, DE
• Providers in Milford, DE by specialty
• Physical Therapy Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; 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.