NPIMap

Organization Active NPI

Earthly Living LLC

  • Physical Therapy Clinic/Center
  • Montclair, NJ
National Provider Identifier
1689346108
Registry record updated Oct 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
EARTHLY LIVING LLC
Practice address
42 Park St.
Montclair, NJ 07042
Phone
(201) 366-2300
NPI assigned
Oct 3, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2021

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

Authorized official

Name
Ashley Twynam, PT, DPTNPI 1972275568
Title
Owner, Member
Phone
(201) 366-2300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

42 Park St.
Montclair, NJ 07042

Mailing address

8 Paterson Ave
Nutley, NJ 07110
Phone (201) 366-2300

National Provider Directory

National Provider Directory
Tax ID family
Earthly Living LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

42 Park St
Montclair, NJ 07042
Phone (201) 366-2300

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1633219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633219200000",
    "number": "1689346108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 PATERSON AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "07110",
            "telephone_number": "201-366-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 PARK ST.",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "07042",
            "telephone_number": "201-366-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARTHLY LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-03",
        "last_updated": "2021-10-03",
        "certification_date": "2021-10-03",
        "status": "A",
        "authorized_official_last_name": "TWYNAM",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER, MEMBER",
        "authorized_official_telephone_number": "201-366-2300",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2021; 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.