Active NPI
Steven Michael Tierney, PT
- Physical Therapist
- Hackettstown, NJ
National Provider Identifier
1699002964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- NJ40QA00716500
- Practice address
- 76 Canada Goose Dr
Hackettstown, NJ 07840-3117 - Phone
- (908) 269-5268
- NPI assigned
- Nov 6, 2009
- 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 | NJ40QA00716500 | NJ | Primary |
Addresses
Primary practice location
76 Canada Goose Dr
Hackettstown, NJ 07840-3117
Mailing address
76 Canada Goose Dr
Hackettstown, NJ 07840-3117
Phone (908) 269-5268
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100113000509 | NJ | Practitioner - Physical Therapist in Private Practice | 4981745981 | Practice locations: Hackettstown, NJ |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NJ40QA00716500 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257465600000",
"number": "1699002964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "76 CANADA GOOSE DR",
"city": "HACKETTSTOWN",
"state": "NJ",
"postal_code": "078403117",
"telephone_number": "908-269-5268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "76 CANADA GOOSE DR",
"city": "HACKETTSTOWN",
"state": "NJ",
"postal_code": "078403117",
"telephone_number": "908-269-5268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIERNEY",
"first_name": "STEVEN",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-11-06",
"last_updated": "2009-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "NJ40QA00716500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hackettstown, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; 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.